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Table 6 Pulmonary hypertension composite score of echocardiographic measures

From: Safety of sildenafil in premature infants with severe bronchopulmonary dysplasia (SILDI-SAFE): a multicenter, randomized, placebo-controlled, sequential dose-escalating, double-masked, safety study

Subjective quantification of RV pressures Absolute criteria Supportive criteria
Septal geometry in systole Shunt directiona RV functionb RV/RA sizec
Normal
(< 1/3 systemic)
Septum round
Eccentricity indexd ≤ 1.0
L to R Normal Normal
Mildly elevated
(1/3–2/3 systemic)
Septal geometry mildly distorted, Eccentricity index 1.01–1.20 L to R Normal Mildly dilated
Moderately elevated
(> 2/3 systemic)
Septum moderately distorted but not flat, Eccentricity index 1.21–1.4 L to R Mildly depressed Mod. dilated
Severely elevated
(≥ systemic)
Septum flat or bowing into left ventricle, Eccentricity index > 1.4 R to L ≥ Mod. depressed Severely dilated
  1. aAcross a PFO, ASD or PDA
  2. bMeasures of RV function to include: subjective estimates, RV fractional area change, tricuspid annular plane systolic excursion, RV strain and strain rate, Myocardial performance index
  3. cRV to RA size based on subjective appearance
  4. dLeft ventricular (LV) eccentricity index (LVEI) = LV antero-posterior diameter / LV septo-lateral diameter
  5. Abbreviations: RV right ventricular, RA right atrial, PFO patent foramen ovale, ASD atrial septal defect, PDA patent ductus arteriosus, LV left ventricular, LVEI left ventricular eccentricity index
  6. Reference: McCrary AW, Barker PCA, Torok RD, Spears TG, Li JS, Hornik CP, et al. agreement of an echocardiogram-based diagnosis of pulmonary hypertension in infants at risk for bronchopulmonary dysplasia among masked reviewers. J Perinatol. 2019;39 (2):248–55