The Left Heart, Systemic Circulation, and Bronchopulmonary Dysplasia: Relevance to Pathophysiology and Therapeutics

Abstract

Improved survival at extremes of gestational age (≤25 weeks) has led to an increase in the number of infants with bronchopulmonary dysplasia (BPD), the most common respiratory complication of preterm birth. The consensus definition of ‘severe’ BPD is requirement of ≥30% oxygen and/or positive pressure respiratory support.1 BPD is a heterogeneous disease, with variable contributions from parenchymal, pulmonary arterial, and pulmonary venous components. In the post-surfactant era, the disease is mainly characterized histologically by fewer, larger, and simplified alveoli with heavily muscularized pulmonary arteries.