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Hemodynamic and Echocardiographic Characteristics and the Presence of Pulmonary Hypertension in Patent Ductus Arteriosus Patients who Underwent Transcatheter Closure

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Abstract

We investigated the hemodynamic parameters of pediatric PDA patients and focused on the influence of PDA size on pulmonary arterial pressure and the prevalence of pulmonary hypertension. A total of 52 patients aged between 2 months and 20 years who received transcatheter closure of a PDA from January 2018 to June 2022 in our institution were retrospectively recruited. Their hemodynamic parameters collected both by echocardiography and by cardiac catheterization were analyzed to delineate the influence of PDA size on the pulmonary vascular system. The echocardiographic-based ductal size and indexed PDA size were 1.93 mm (1.15–6 mm) and 4.05 mm/m2 (2.03–25.47 mm/m2), respectively. The pulmonary artery pressure measured was 20.83 mmHg (8–45 mmHg). We found a positive correlation between indexed PDA size and mean pulmonary arterial pressure (mPAP) (Pearson correlation coefficient = 0.47, p < 0.001). A subgroup analysis showed that 28 patients (53.8%) developed pulmonary hypertension (PH) (defined as mPAP > 20 mmHg). The median age of the PH group was 1.02 years [range: 0.19–8.64], which was significantly younger than the non-PH group's median age of 3.43 years [range: 0.42–19.96] (p = 0.001). The indexed PDA size for the PH group, 4.69 mm/m2, was significantly higher than that of the non-PH group, 3.2 mm/m2 (p = 0.004). The major risk factor for patients with PH was the PDA/BSA index, with an OR of 2.181 (95% CI, 1.224–3.887). Our demographic data showed younger patients with a higher PDA/BSA index are more likely to develop pulmonary hypertension.

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Data Availability

The data that support the findings of this study are available on request from the corresponding author (W-LH).

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Acknowledgements

The authors would like to express their gratitude to the experienced echocardiograph technicians Hisu-Chin Peng and Lin-Ya Hung for their expertise and dedication to patients.

Funding

No funding was secured for this study.

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Authors and Affiliations

  1. Department of Pediatric Cardiology, Mackay Children’s Hospital, Taipei, Taiwan

    Po-Wei Wu, Shu-Jen Yeh, Chih-Wei Tien, Yen-Chun Chao, Shan-Miao Lin, Ming-Ren Chen & Wei-Li Hung

  2. Division of Pediatric Cardiology, Department of Pediatrics, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan

    Po-Wei Wu

  3. Department of Medical Education, Taichung Veterans General Hospital, Taichung, Taiwan

    Pi-Chang Lee

  4. Institute of Environmental Design and Engineering, Bartlett School, UCL, London, UK

    Ke-Ting Pan

  5. Graduate Institute of Aerospace and Undersea Medicine, National Defense Medical Center, Taipei, Taiwan

    Ke-Ting Pan

  6. Department of Pediatric Cardiology, Mackay Memorial Hospital, Tamsui Branch, New Taipei City, Taiwan

    Shan-Miao Lin

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Contributions

All authors contributed to the study conception and design. PWW and WLH: contributed to material preparation, data collection, and analysis. PWW: contributed to writing the first draft of the manuscript. All authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Wei-Li Hung.

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The study was approved by the institutional ethics committee (22MMHIS211e), and the requirement of written consent was waived.

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Wu, PW., Yeh, SJ., Lee, PC. et al. Hemodynamic and Echocardiographic Characteristics and the Presence of Pulmonary Hypertension in Patent Ductus Arteriosus Patients who Underwent Transcatheter Closure. Pediatr Cardiol 44, 1262–1270 (2023). https://doi.org/10.1007/s00246-023-03157-2

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