Table 4.

Future research directions in BPD-PH.

New discoveries in the pathobiology

Mechanistic studies on the pathobiology of BPD-PH and the role of common neonatal conditions such as respiratory support, surfactant, nutritional care, ductus arteriosus and inflammation on the developing pulmonary vasculature

Investigating mechanisms of right heart adaptation and remodeling in preterm infants with and without BPD

Identification of risk factors

Identification of pre- and postnatal risk factors relevant for the development of PHVD/PH in BPD infants

Identification of preventive measures against PHVD/PH during the fetal and early neonatal periods

Role of genetic risk factors in the pathogenesis of BPD-PH

Role of cardiac catheterization and advanced imaging (CT/CMR) in severe BPD-PH

Early detection

Clinical and echocardiographic parameters for early detection of PHVD/PH in preterm infants at risk for BPD

Innovative and efficient therapies

Research on underlying beneficial mechanisms, mode of delivery, and efficacy of stem-cell-based therapies, including cell-free preparation (e.g., conditioned media, exosome-based therapies)

Trials on the safety and efficacy of pulmonary vasodilatory therapy in preterm infants with BPD-PH

Potential role of vasodilatory combination therapy for BPD-PH

Potential role of new PAH-drugs, such as macitentan, selexipag, riociguat in BPD-PH

Clinical follow-up

Further research on biomarkers in BPD-PH (early detection and follow-up)

Definition of comprehensive multidisciplinary follow-up protocols, including neurodevelopmental aspects

BPD-PH bronchopulmonary dysplasia-associated pulmonary hypertension, CT computerized tomography, CMR cardiac magnetic resonance, PHVD pulmonary hypertensive vascular disease.