“Pulmonary Vascular Disease of Prematurity: Navigating the Phenotypes”

Saturday, April 29, 2023

2:00 PM – 3:30 PM ET

Location: Convention Center: 152 B

CE: Live CME: 1.50

Selected By: Neonatal

Chair(s)

SA

Steve Abman, MD (he/him/his)

Professor
University of Colorado School of Medicine
AUrora, Colorado, United States
Patrick McNamara, MB, BCH, BAO, DCH, MSc (Paeds), MRCP, MRCPCH, FASE

Professor of Pediatrics-Neonatology
Pediatrics
University of Iowa Stead Family Children's Hospital
Iowa City, Iowa, United States

Disclosure(s):

Steve Abman, MD: Oak Hills Bio (Ongoing) (Products/Services: Advisory Committee)

Patrick J. J. Mcnamara, MD MSc: Abbott Cardiac: Speaker Honorarium including speakers bureau, symposia, and expert witness (Ongoing); Aspect Imaging: Consultant (Ongoing)

Session

Description: Pulmonary hypertension (PH) contributes to high morbidity and mortality in preterm infants, yet mechanisms contributing to PH, the impact of pulmonary vascular disease (PVD) on the clinical course with acute hypoxemic respiratory failure, its impact on outcomes of preterm infants, the role for PH-targeted drug therapies, and long-term sequelae in late childhood and adulthood are poorly understood. PVD in preterm infants includes diverse phenotypes as defined by timing of onset, severity and contributions to late outcomes. As with term newborns, preterm infants can develop acute hypoxemic respiratory failure (HRF) with systemic levels of pulmonary artery pressure, known as persistent pulmonary hypertension of the newborn (PPHN), and variable levels of early PH have also been demonstrated in preterm infants without severe HRF, representing the delayed pulmonary vascular transition (DPVT) of the lung, which has been associated with higher risk of mortality, prolonged ventilation and BPD. Furthermore, echocardiographic evidence of PH in the early weeks of life is strongly associated with BPD, late PH, and clinical respiratory disease during early childhood. Past studies of older infants and children have shown that echocardiographic signs of PVD can persist and may lead to chronic PH in prematurely-born young adults. Overall, this symposium will present the importance of understanding PVD pathogenesis and characterize the diverse pulmonary vascular phenotypes in preterm infants that may help to guide clinical care and lead to the development of more specific preventive and therapeutic strategies to optimize outcomes of preterm infants.

Learning Objectives:

understand the physiologic basis and develop therapeutic strategies to improve the care of preterm infants with severe acute pulmonary hypertension shortly after birth.
define the physiology and outcomes of preterm infants with variable patterns of delayed pulmonary vascular transition (DPVT) during the first days and weeks of life.
develop a clinical strategy for the care of PH in preterm infants with BPD and to anticipate the risk for late PH in early adulthood.

Presentations:

2:00 PM – 2:05 PM ET

Introduction
Speaker: Steve Abman, MD (he/him/his) – University of Colorado School of Medicine
2:05 PM – 2:25 PM ET

Lung Vascular Development: the Rare Informs the Common
Speaker: Vladimir Kalinichenko, MD, PhD – University of Arizona College of Medicine - Phoenix and Phoenix Children's Hospital
2:25 PM – 2:45 PM ET

Physiology-Based Management of acute PH in Preterm Infants
Speaker: Patrick J. McNamara, MB, BCH, BAO, DCH, MSc (Paeds), MRCP, MRCPCH, FASE (he/him/his) – University of Iowa Stead Family Department of Pediatrics
2:45 PM – 3:05 PM ET

Delayed Pulmonary Vascular Transition in Premature Newborns
Speaker: Hussnain S. Mirza, MD. FAAP. MBA (he/him/his) – UCF College of Medicine/ Advent Health for Children
3:05 PM – 3:25 PM ET

Novel Strategies for the Treatment of BPD-Associated PH
Speaker: Karen Young – University of Miami Leonard M. Miller School of Medicine