Left atrial hypertension (LAH) may contribute to pulmonary hypertension (PH) in premature infants with bronchopulmonary dysplasia (BPD). Primary causes of LAH in infants with BPD include left ventricular diastolic dysfunction or hemodynamically significant left to right shunt. The incidence of LAH, which is definitively diagnosed by cardiac catheterization, and its contribution to PH is unknown in patients with BPD-PH. We report the prevalence of LAH in an institutional cohort with BPD-PH with careful examination of hemodynamic contributors and impact on patient outcomes. This single-center, retrospective cohort study examined children <2 years of age with BPD-PH who underwent cardiac catheterization at Lucile Packard Children's Hospital Stanford. Patients with unrepaired simple shunt congenital heart disease (CHD) and pulmonary vein stenosis (only 1 or 2 vessel disease) were included. Patients with complex CHD were excluded. From April 2010 to December 2021, 34 patients with BPD-PH underwent cardiac catheterization. We define LAH as pulmonary capillary wedge pressure (PCWP) or left atrial pressure (LAP) of at least 10 mmHg. In this cohort, median PCWP was 8 mmHg, with LAH present in 32% (n = 11) of the total cohort. A majority (88%, n = 30) of the cohort had severe BPD. Most patients had some form of underlying CHD and/or pulmonary vein stenosis: 62% (n = 21) with an atrial septal defect or patent foramen ovale, 62% (n = 21) with patent ductus arteriosus, 12% (n = 4) with ventricular septal defect, and 12% (n = 4) with pulmonary vein stenosis. Using an unadjusted logistic regression model, baseline requirement for positive pressure ventilation at time of cardiac catheterization was associated with increased risk for LAH (odds ratio 8.44, 95% CI 1.46–48.85, p = 0.02). Small for gestational age birthweight, sildenafil use, and CHD were not associated with increased risk for LAH. LAH was associated with increased risk for the composite outcome of tracheostomy and/or death, with a hazard ratio of 6.32 (95% CI 1.72, 22.96; p = 0.005). While the etiology of BPD-PH is multifactorial, LAH is associated with PH in some cases and may play a role in clinical management and patient outcomes.

左心房高压 (LAH) 可能导致支气管肺发育不良 (BPD) 早产儿的肺动脉高压 (PH)。BPD 婴儿 LAH 的主要原因包括左心室舒张功能障碍或血流动力学显着的左向右分流。在 BPD-PH 患者中，LAH 的发生率（通过心导管术明确诊断）及其对 PH 的影响尚不清楚。我们报告了 BPD-PH 机构队列中 LAH 的患病率，并仔细检查了血流动力学因素和对患者预后的影响。这项单中心、回顾性队列研究检查了在斯坦福露西尔帕卡德儿童医院接受心导管插入术的 2 岁以下患有 BPD-PH 的儿童。包括未修复的单纯性分流先天性心脏病 (CHD) 和肺静脉狭窄（仅 1 或 2 支血管病变）的患者。排除复杂性冠心病患者。2010 年 4 月至 2021 年 12 月，34 名 BPD-PH 患者接受了心导管插入术。我们将 LAH 定义为至少 10 mmHg 的肺毛细血管楔压 (PCWP) 或左心房压 (LAP)。在该队列中，中位 PCWP 为 8 mmHg，LAH 占 32%（n= 11) 的总队列。多数（88%，n= 30) 的队列有严重的 BPD。大多数患者有某种形式的潜在冠心病和/或肺静脉狭窄：62%（n= 21) 有房间隔缺损或卵圆孔未闭，62% (n= 21) 动脉导管未闭，12% (n= 4) 有室间隔缺损，12% (n= 4) 伴有肺静脉狭窄。使用未经调整的逻辑回归模型，心导管插入术时对正压通气的基线要求与 LAH 风险增加相关（比值比 8.44，95% CI 1.46–48.85，p= 0.02)。小于胎龄儿、使用西地那非和冠心病与 LAH 风险增加无关。LAH 与气管切开术和/或死亡的复合结局风险增加相关，风险比为 6.32（95% CI 1.72, 22.96；p = 0.005). While the etiology of BPD-PH is multifactorial, LAH is associated with PH in some cases and may play a role in clinical management and patient outcomes.

左心房高压 (LAH) 可能导致支气管肺发育不良 (BPD) 早产儿的肺动脉高压 (PH)。BPD 婴儿 LAH 的主要原因包括左心室舒张功能障碍或血流动力学显着的左向右分流。在 BPD-PH 患者中，LAH 的发生率（通过心导管术明确诊断）及其对 PH 的影响尚不清楚。我们报告了 BPD-PH 机构队列中 LAH 的患病率，并仔细检查了血流动力学因素和对患者预后的影响。这项单中心、回顾性队列研究检查了在斯坦福露西尔帕卡德儿童医院接受心导管插入术的 2 岁以下患有 BPD-PH 的儿童。包括未修复的单纯性分流先天性心脏病 (CHD) 和肺静脉狭窄（仅 1 或 2 支血管病变）的患者。排除复杂性冠心病患者。2010 年 4 月至 2021 年 12 月，34 名 BPD-PH 患者接受了心导管插入术。我们将 LAH 定义为至少 10 mmHg 的肺毛细血管楔压 (PCWP) 或左心房压 (LAP)。在该队列中，中位 PCWP 为 8 mmHg，LAH 占 32%（n= 11) 的总队列。多数（88%，n= 30) 的队列有严重的 BPD。大多数患者有某种形式的潜在冠心病和/或肺静脉狭窄：62%（n= 21) 有房间隔缺损或卵圆孔未闭，62% (n= 21) 动脉导管未闭，12% (n= 4) 有室间隔缺损，12% (n= 4) 伴有肺静脉狭窄。使用未经调整的逻辑回归模型，心导管插入术时对正压通气的基线要求与 LAH 风险增加相关（比值比 8.44，95% CI 1.46–48.85，p= 0.02)。小于胎龄儿、使用西地那非和冠心病与 LAH 风险增加无关。LAH 与气管切开术和/或死亡的复合结局风险增加相关，风险比为 6.32（95% CI 1.72, 22.96；p= 0.005)。虽然 BPD-PH 的病因是多因素的，但 LAH 在某些情况下与 PH 相关，并且可能在临床管理和患者预后中发挥作用。