Abstract: Objective To explore the influence of plateau atmospheric environment on the incidence of patent ductus arteriosus (PDA) and pulmonary artery pressure (PAP) in children. Methods? The clinical data of children at different elevations in Yunnan province who received interventional cardiac catheterization and PAP determination from 2016 to 2019 were analyzed retrospectively. Pulmonary artery systolic pressure (PASP), pulmonary artery diastolic pressure (PADP) and mean PAP (mPAP) were measured by the COOK 5 F interventional guide catheter and LLC PX 260 pressure sensor in children with PDA alone. The altitude of residence was queried through satellite maps. Results Among the 266 children with PDA alone, the mPAP of the children living at altitudes less than 1500 m and more than 1500 m were ( 24 . 0 ± 5 . 8 ) and ( 25 . 1 ± 8 . 4 ) mmHg respectively, which were close to or higher than the diagnostic threshold of pulmonary hypertension ( 25 mmHg) in children. The mPAP level of children showed an increasing trend with the increase of PDA diameter and the altitude of residence. The analysis of variance showed that there were significant differences in PASP, PADP, and mPAP among PDA children living at different altitudes and with different PDA diameters (P< 0 . 05 ). Multiple linear regression analysis showed that there was a positive correlation between PDA diameter and mPAP (P< 0 . 001 ). Conclusions Exposure to atmosphere of low pressure and low oxygen may be one of the important factors that lead to the incidence of PDA and the persistence of high PAP in children in plateau areas. As the altitude at residence was elevated and the diameter was increased, PDA-induced pulmonary hypertension becomes more prominent. These children may gain more health benefits from occlusion treatment.

Key words: patent ductus arteriosus; pulmonary artery pressure; cardiac catheterization; child