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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