Journal article
Assessment of myocardial performance in preterm infants less than 29 weeks gestation during the transitional period
Early human development, Vol.90(12), pp.829-835
12/2014
DOI: 10.1016/j.earlhumdev.2014.09.004
PMID: 25463828
Abstract
The transitional circulation and its effect on myocardial performance are poorly understood in preterm infants.
We assessed myocardial performance in infants less than 29weeks gestation in the first 48h of life using a comprehensive echocardiographic assessment.
Infants <29weeks gestation were prospectively enrolled. Small for gestation, infants on inotropes and/or inhaled nitric oxide and septic infants were excluded. Conventional echocardiography, left ventricular (LV), septal and right ventricular (RV) tissue Doppler imaging (TDI) and tissue Doppler-derived strain and strain rate (SR), tricuspid annular plane systolic excursion (TAPSE) and global RV fractional area change (FAC) were assessed at a median of 10 and 45h post-delivery.
Fifty-four infants with a median [IQR] gestation and birth weight of 26.5 weeks [25.8–28.0 weeks] and 915 g [758–1142 g] were included. There was no change in shortening or ejection fraction across the two time points. Systolic and diastolic TDI of the LV, septum and RV increased across the two time points (all p values≤0.01). There was an increase in septal peak systolic and early diastolic SR (p=0.002). Septal systolic strain and late diastolic SR did not change. With the exception of RV strain and early diastolic SR, all RV functional parameters including SR, late diastolic SR, TAPSE, and FAC increased across the two time points (all p values<0.01).
Describing the normal hemodynamic adaptations in stable preterm infants during the transitional period provides the necessary information for the assessment of those parameters in various disease states.
•Left and right ventricular strain and strain rate are measurable in preterm infants.•Right ventricular-specific function parameters are reliable in preterm infants.•Conventional echo function markers do not detect a change in the first 48h.•Novel echo markers of function demonstrate improvement over the first 48h.•Those novel markers may be more sensitive in detecting compromise in disease states.
Details
- Title: Subtitle
- Assessment of myocardial performance in preterm infants less than 29 weeks gestation during the transitional period
- Creators
- Adam T James - Department of Paediatrics, The Rotunda Hospital, Dublin, IrelandJohn D Corcoran - Department of Paediatrics, The Rotunda Hospital, Dublin, IrelandAmish Jain - Department of Paediatrics, Mount Sinai Hospital, Toronto, CanadaPatrick J McNamara - Physiology and Experimental Medicine, Hospital for Sick Children, Toronto, CanadaLuc Mertens - The Labatt Family Heart Centre, The Hospital for Children, Toronto, CanadaOrla Franklin - Department of Cardiology, Our Lady's Children's Hospital Crumlin, Dublin, IrelandAfif F EL-Khuffash - Department of Paediatrics, The Rotunda Hospital, Dublin, Ireland
- Resource Type
- Journal article
- Publication Details
- Early human development, Vol.90(12), pp.829-835
- Publisher
- Elsevier Ireland Ltd
- DOI
- 10.1016/j.earlhumdev.2014.09.004
- PMID
- 25463828
- ISSN
- 0378-3782
- eISSN
- 1872-6232
- Language
- English
- Date published
- 12/2014
- Academic Unit
- Stead Family Department of Pediatrics; Neonatology; Internal Medicine
- Record Identifier
- 9984093315102771
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