Journal article
Left ventricular function before and after percutaneous patent ductus arteriosus closure in preterm infants
Pediatric research, Vol.94(1), pp.213-221
07/2023
DOI: 10.1038/s41390-022-02372-6
PMID: 36380071
Abstract
Background Definitive closure of the patent ductus arteriosus (PDA) is associated with significant changes in the loading conditions of the left ventricle (LV), which may lead to cardiovascular and respiratory instability. The objective of the study was to evaluate targeted neonatal echocardiography (TnECHO) characteristics and the clinical course of preterm infants <= 2 kg undergoing percutaneous PDA closure. Methods Retrospective cohort study of prospectively acquired pre- and post-closure TnECHOs to assess hemodynamic changes. Cardiorespiratory parameters in the first 24 h following PDA closure were also evaluated. Results Fifty patients were included with a mean age of 30.6 +/- 9.6 days and weight of 1188 +/- 280 g. LV global longitudinal strain decreased from -20.6 +/- 2.6 to -14.9 +/- 2.9% (p < 0.001) after 1 h. There was a decrease in LV volume loading, left ventricular output, LV systolic and diastolic parameters. Cardiorespiratory instability occurred in 24 (48%) [oxygenation failure in 44%] but systolic hypotension and/or need for cardiovascular medications was only seen in 6 (12%). Patients with instability had worse baseline respiratory severity score and lower post-closure early diastolic strain rates. Conclusions Percutaneous PDA closure leads to a reduction in echocardiography markers of LV systolic/diastolic function. Post-closure cardiorespiratory instability is characterized primarily by oxygenation failure and may relate to impaired diastolic performance. Impact Percutaneous patent ductus arteriosus closure leads to a reduction in echocardiography markers of left ventricular volume loading, cardiac output, and left ventricular systolic/diastolic function. Post-procedural cardiorespiratory instability is characterized primarily by oxygenation failure. Post-procedural cardiorespiratory instability may relate to impaired diastolic performance.
Details
- Title: Subtitle
- Left ventricular function before and after percutaneous patent ductus arteriosus closure in preterm infants
- Creators
- Adrianne Rahde Bischoff - University of IowaAmy H. Stanford - University of IowaOsamah Aldoss - University of IowaDanielle R. Rios - University of IowaDaniel McLennan - Herma Heart Inst, Sect Pediat Cardiol, Milwaukee, WI USABassel Mohammad Nijres - University of IowaRegan E. Giesinger - University of IowaPatrick J. McNamara - Univ Iowa, Dept Pediat, Div Neonatol, Iowa City, IA 52242 USA
- Resource Type
- Journal article
- Publication Details
- Pediatric research, Vol.94(1), pp.213-221
- Publisher
- Springer Nature
- DOI
- 10.1038/s41390-022-02372-6
- PMID
- 36380071
- ISSN
- 0031-3998
- eISSN
- 1530-0447
- Number of pages
- 9
- Language
- English
- Electronic publication date
- 11/15/2022
- Date published
- 07/2023
- Academic Unit
- Stead Family Department of Pediatrics; Neonatology; Internal Medicine
- Record Identifier
- 9984354056002771
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