Early risk stratification in preterm infants with Bronchopulmonary Dysplasia via pulmonary arterial flow measurements in MRI

Despite clinical significance of Pulmonary Hypertension resulting from failed development of the gas exchange area in preterms with Bronchopulmonary Dysplasia (BPD) early markers and diagnostic tools to detect aberrant vascular development are missing. To improve early diagnosis in clinical routine, 85 preterm infants PA-flow correlates in both lungs, is decreased in BPD infants and correlates with the days of oxygen supply and mechanical ventilation. Echocardiographic signs of right ventricle strain and proteins involved in angiogenesis, vascular injury, matrix remodeling and inflammatory processes (e.g. BMP7, PKCA, Siglec14) are negatively correlated to PA-flow. A wide range of PA-flow in infants with similar emphysematous changes and interstitial lung remodeling indicates an underlying vascular phenotype. PA-flow measurements in infants are feasible and correlate with the presence of BPD. Detailed analyses indicate subgroups of infants with more severe reduction in PA-flow adding to the detected severity of lung remodeling and associated with promising biomarkers as potential early indicators of vascular disease.