Journal article
Maturational Patterns of Systolic Ventricular Deformation Mechanics by Two-Dimensional Speckle-Tracking Echocardiography in Preterm Infants over the First Year of Age
Journal of the American Society of Echocardiography, Vol.30(7), pp.685-698.e1
07/2017
DOI: 10.1016/j.echo.2017.03.003
PMCID: PMC5495609
PMID: 28433214
Abstract
The aim of this study was to determine the maturational changes in systolic ventricular strain mechanics by two-dimensional speckle-tracking echocardiography in extremely preterm neonates from birth to 1 year of age and discern the impact of common cardiopulmonary abnormalities on the deformation measures.
In a prospective multicenter study of 239 extremely preterm infants (<29 weeks gestation at birth), left ventricular (LV) global longitudinal strain (GLS) and global longitudinal systolic strain rate (GLSRs), interventricular septal wall (IVS) GLS and GLSRs, right ventricular (RV) free wall longitudinal strain and strain rate, and segmental longitudinal strain in the RV free wall, LV free wall, and IVS were serially measured on days 1, 2, and 5 to 7, at 32 and 36 weeks postmenstrual age, and at 1 year corrected age (CA). Premature infants who developed bronchopulmonary dysplasia or had echocardiographic findings of pulmonary hypertension were analyzed separately.
In uncomplicated preterm infants (n = 103 [48%]), LV GLS and GLSRs remained unchanged from days 5 to 7 to 1 year CA (P = .60 and P = .59). RV free wall longitudinal strain, RV free wall longitudinal strain rate, and IVS GLS and GLSRs significantly increased over the same time period (P < .01 for all measures). A significant base-to-apex (highest to lowest) segmental longitudinal strain gradient (P < .01) was seen in the RV free wall and a reverse apex-to-base gradient (P < .01) in the LV free wall. In infants with bronchopulmonary dysplasia and/or pulmonary hypertension (n = 119 [51%]), RV free wall longitudinal strain and IVS GLS were significantly lower (P < .01), LV GLS and GLSRs were similar (P = .56), and IVS segmental longitudinal strain persisted as an RV-dominant base-to-apex gradient from 32 weeks postmenstrual age to 1 year CA.
This study tracks the maturational patterns of global and regional deformation by two-dimensional speckle-tracking echocardiography in extremely preterm infants from birth to 1 year CA. The maturational patterns are ventricular specific. Bronchopulmonary dysplasia and pulmonary hypertension leave a negative impact on RV and IVS strain, while LV strain remains stable.
•Two-dimensional (2D) speckle-tracking echocardiography (STE)–derived myocardial strain is a feasible and reproducible imaging modality that can be used to characterize systolic ventricular function in premature infants.•This study establishes ventricular-specific systolic strain maturational patterns by 2D STE in a large cohort of extremely preterm infants from birth through 1 year corrected age.•Common cardiopulmonary morbidities, such as bronchopulmonary dysplasia and pulmonary hypertension, appear to leave a negative impact on right ventricular strain, while left ventricular strain remains stable through the first year of age.•With the establishment of the range of maturational patterns of strain mechanics and associated variations up to 1 year corrected age, deformation imaging by 2D STE may now be implemented in preterm infants as a means to identify cardiovascular compromise earlier, guide therapeutic intervention, monitor treatment response, and improve overall outcome.
Details
- Title: Subtitle
- Maturational Patterns of Systolic Ventricular Deformation Mechanics by Two-Dimensional Speckle-Tracking Echocardiography in Preterm Infants over the First Year of Age
- Creators
- Philip T Levy - Department of Pediatrics, Washington University School of Medicine, St. Louis, MissouriAfif EL-Khuffash - Department of Neonatology, The Rotunda Hospital, Dublin, IrelandMeghna D Patel - Department of Pediatrics, Washington University School of Medicine, St. Louis, MissouriColm R Breatnach - Department of Neonatology, The Rotunda Hospital, Dublin, IrelandAdam T James - Department of Neonatology, The Rotunda Hospital, Dublin, IrelandAura A Sanchez - Department of Pediatrics, University of Minnesota, Minneapolis, MinnesotaCristina Abuchabe - Department of Pediatrics, Washington University School of Medicine, St. Louis, MissouriSarah R Rogal - Department of Pediatrics, Goryeb Children's Hospital, Morristown, New JerseyMark R Holland - Department of Radiology and Imaging Sciences, Indiana University Purdue University, Indianapolis, IndianaPatrick J McNamara - Division of Neonatology and Department of Physiology, The Hospital for Sick Children, Toronto, Ontario, CanadaAmish Jain - Department of Paediatrics, Mount Sinai Hospital, Toronto, Ontario, CanadaOrla Franklin - Department of Cardiology, Our Lady’s Children’s Hospital Crumlin, Dublin, IrelandLuc Mertens - Division of Cardiology, The Labatt Family Heart Centre, The Hospital for Children, Toronto, Ontario, CanadaAaron Hamvas - Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IllinoisGautam K Singh - Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri
- Resource Type
- Journal article
- Publication Details
- Journal of the American Society of Echocardiography, Vol.30(7), pp.685-698.e1
- DOI
- 10.1016/j.echo.2017.03.003
- PMID
- 28433214
- PMCID
- PMC5495609
- NLM abbreviation
- J Am Soc Echocardiogr
- ISSN
- 0894-7317
- eISSN
- 1097-6795
- Publisher
- Elsevier Inc
- Language
- English
- Date published
- 07/2017
- Academic Unit
- Stead Family Department of Pediatrics; Neonatology; Internal Medicine
- Record Identifier
- 9984093333302771
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