Emerging Echocardiographic Indices for the Assessment of Pulmonary Hypertension in Infants of Diabetic Mothers. A Prospective Cross -Sectional Study | ||
| Annals of Neonatology | ||
| Articles in Press, Accepted Manuscript, Available Online from 10 September 2025 | ||
| Document Type: Original Article | ||
| DOI: 10.21608/anj.2025.407877.1118 | ||
| Authors | ||
| Ibtehal Saad Ali; Gamal Baheeg Mohamed; Khaled Mahrous Khaled; Reham Sayed Ahmed* | ||
| Pediatrics Department, Faculty of Medicine, Minia University, Egypt, | ||
| Abstract | ||
| Background: Infants of diabetic mothers (IDMs) are at increased risk of developing pulmonary hypertension (PH), a condition associated with significant neonatal morbidity. Echocardiography is a key non-invasive tool for early PH detection. Recently, pulmonary artery acceleration time (PAAT) and the PAAT to right ventricular ejection time (PAAT/RVET) ratio have emerged as promising indicators of pulmonary vascular resistance. Aim: To evaluate the diagnostic accuracy of PAAT and PAAT/RVET ratio in detecting PH in IDMs and compare them with conventional echocardiographic parameters. Patients and Methods: A cross-sectional study included 50 IDMs admitted to a tertiary level NICU and 50 age - and sex - matched healthy neonates. All underwent transthoracic echocardiography to assess PAAT, PAAT/RVET ratio, tricuspid regurgitation peak gradient (TRPG), and systolic pulmonary artery pressure (SPAP). Results: IDMs with PH had significantly lower PAAT and PAAT/RVET ratios, and higher SPAP compared to controls (p < 0.001). PAAT showed excellent diagnostic performance (AUC 0.957) with a cut-off <74 ms (92% sensitivity, 96% specificity). The PAAT/RVET ratio had even higher accuracy (AUC 0.968) at a cut-off ≤0.36 (94% sensitivity, 96% specificity). SPAP showed lower diagnostic value (AUC 0.838). Conclusions: PAAT and PAAT/RVET ratio are effective, non-invasive echocardiographic markers for early PH detection in IDMs, with superior diagnostic performance compared to traditional Doppler-based measures methods. | ||
| Keywords | ||
| Infants of diabetic mothers; Pulmonary artery acceleration time; Right ventricular ejection time | ||
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