Cardiac Function After the Immediate Transitional Period in Very Preterm Infants Using Speckle Tracking Analysis

Waal, Koert de; Phad, Nilkant; Lakkundi, Anil; Tan, Peter

doi:10.1007/s00246-015-1277-3

Cited by 28 publications

(40 citation statements)

References 34 publications

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“…Nasu et al performed eight serial echocardiograms over the first 72 hours of age and demonstrated no change in LV strain. 8 Czernik et al 14 and de Waal et al 12 each serially observed stable 2DSTE-derived LV GLS in preterm infants from birth to 28 days of age. Hirose et al demonstrated that clinically healthy preterm infants (delivered at < 30 weeks gestation) also have constant 2DSTE-derived LV strain measures from 28 days of age to near term equivalent age (3 months CA).…”

Section: Discussionmentioning

confidence: 96%

“…de Waal et al also found higher LV GLS and SRs in infants with a PDA. 12 It is well documented that a hsPDA significantly increases LV preload, and leads to an increase in LV output. 48 The increase in preload is accompanied by an increase in S but not SRs.…”

Section: Discussionmentioning

confidence: 97%

“…9,10 In addition, deformation imaging has been mostly limited to the early postnatal period in preterm infants. 1,6–8,10,12–14,16,21,35 We leveraged the large cohort of preterm infants in a multi-center format to study the impact of prematurity on the maturation of cardiac function in the preterm infants. 18 This is the largest study to longitudinally assess strain imaging with 2DSTE in preterm infants up to one year CA.…”

Section: Discussionmentioning

confidence: 99%

“…7,8,12–14,16 This is the first study to calculate the true “global” strain as an average from the three apical views. 32 We further speculate that this difference is one reason for the disparity in reported values between studies, as well as the observed increase in LV GLS from Day 1 to Day 5–7 in our study.…”

Section: Discussionmentioning

confidence: 99%

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Maturational Patterns of Systolic Ventricular Deformation Mechanics by Two-Dimensional Speckle-Tracking Echocardiography in Preterm Infants over the First Year of Age

Levy

El-Khuffash

Patel

et al. 2017

Journal of the American Society of Echocardiography

144

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Background We aimed to determine the maturational changes in systolic ventricular strain mechanics by two-dimensional speckle tracking echocardiography in extreme preterm neonates from birth to one year of age, and discern the impact of common cardiopulmonary abnormalities on the deformation measures. Methods In a prospective multi-center study of 239 extreme preterm infants (< 29 weeks gestation at birth), left ventricle (LV) global longitudinal strain and systolic strain rate (GLS, GLSRs), interventricular septal wall (IVS) GLS and GLSRs, right ventricle free wall longitudinal S and SR (RV FWLS, FWLSRs), and segmental LS (SLS) in the RVFW, LVFW and IVS were serially measured at Days 1, 2, 5–7, 32 weeks and 36 weeks post-menstrual age (PMA), and one year corrected age (CA). Premature infants who developed bronchopulmonary dysplasia (BPD) or had echocardiographic findings of pulmonary hypertension (PH) were analyzed separately. Results In uncomplicated preterm infants (n=103, 48%), LV GLS and GLSRs remained unchanged from Day 5–7 to one year CA (p=0.60 and 0.59). RV FWLS, FWLSRs and IVS GLS and GLSR significantly increased over the same time period (p < 0.01 for all measures). A significant base-to-apex (highest to lowest) SLS gradient (p < 0.01) in the RVFW and a reverse apex-to-base gradient (p < 0.01) existed in the LVFW. In infants with BPD and/or PH (n=119, 51%), RV FWLS and IVS GLS were significantly lower (p < 0.01), LV GLS and GLSRs were similar (p=0.56), and IVS SLS persisted as an RV dominant base-to-apex gradient from 32 weeks PMA to one year CA. Conclusions This study tracks the maturational patterns of global and regional deformation by 2DSTE in extreme preterm infants from birth to one year CA. The maturational patterns are ventricular specific. BPD and PH leave a negative impact on RV and IVS strain, while LV strain remains stable.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Maturational Patterns of Systolic Ventricular Deformation Mechanics by Two-Dimensional Speckle-Tracking Echocardiography in Preterm Infants over the First Year of Age

Levy

El-Khuffash

Patel

et al. 2017

Journal of the American Society of Echocardiography

144

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“…There is an expanding body of literature on strain and SR in term and preterm infants using both cDTI and STE techniques [8,31,44,49,[56][57][58] . Current research is evaluating the ability of ε and SR to characterize the physiological and pathological changes in diseases such hypoxic ischaemic encephalopathy, pulmonary hypertension, li- gation of a patent ductus arteriosus, and chronic lung disease.…”

Section: Deformation Imagingmentioning

confidence: 99%

Novel Echocardiography Methods in the Functional Assessment of the Newborn Heart

et al. 2016

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Echocardiography in the neonatal intensive care unit has led to improvements in our ability to assess the neonatal heart in health and disease. Advances in neonatal cardiac imaging have provided the capability to obtain quantitative information that often supersedes the qualitative information provided by conventional methods. Novel quantitative measures of function include the assessment of the velocity of muscle tissue movement during systole and diastole using tissue Doppler velocity imaging, and evaluation of deformation and rotational characteristics of the myocardium utilizing speckle tracking echocardiography or tissue Doppler-derived strain imaging. A comprehensive understanding of these novel functional modalities, their predictive value, and limitations can greatly assist in managing both the normal and maladaptive responses in the newborn period. This article discusses the novel and emerging methods for assessment of left and right heart function in the neonatal population.

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Does chest wall conformation influence myocardial strain parameters in infants with pectus excavatum?

Sonaglioni

Nicolosi²,

Braga

et al. 2021

J of Clinical Ultrasound

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Purpose To investigate the possible influence of chest wall conformation on myocardial strain parameters in a consecutive population of infants with pectus excavatum (PE), noninvasively assessed by modified Haller index (MHI). Methods Sixteen consecutive PE infants (MHI >2.5) and 44 infants with normal chest shape (MHI ≤2.5) entered in this prospective case–control study. All infants underwent evaluation by neonatologist, transthoracic echocardiography implemented with two‐dimensional speckle tracking echocardiography (2D‐STE) analysis of both ventricles and MHI assessment (ratio of chest transverse diameter over the distance between sternum and spine), at two time points: within 3 days and at about 40 days of life. Results At 2.1 ± 1 days of life, compared to controls (MHI = 2.01 ± 0.2), PE infants (MHI = 2.76 ± 0.2) were diagnosed with significantly smaller cardiac chambers dimensions. Biventricular contractile function and hemodynamics were similar in both groups of infants. Left ventricular (LV) global longitudinal strain (GLS) (−16.0 ± 2.8 vs. −21.7 ± 2.2%), LV‐global circumferential strain (GCS) (−16.3 ± 2.7 vs. −24.0 ± 5.2%), LV‐global radial strain (GRS) (24.2 ± 3.0 vs. 31.5 ± 6.3%), and right ventricular free wall longitudinal strain (RVFWLS) (−16.0 ± 3.2 vs. −22.3 ± 4.4%) were significantly reduced in PE infants versus controls (all p < 0.001). A strong inverse correlation between MHI and the following parameters: LV‐GLS (r = −0.92), LV‐GCS (r = −0.88), LV‐GRS (r = −0.87), and RVFWLS (r = −0.88), was demonstrated in PE infants, but not in controls, in perinatal period (all p < 0.001). Analogous results were obtained at 36.8 ± 5.2 days after birth. Conclusions Abnormal chest anatomy progressively impairs myocardial strain parameters in PE infants. This impairment might reflect intraventricular dyssynchrony due to compressive phenomena rather than intrinsic myocardial dysfunction.

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Cardiac Function After the Immediate Transitional Period in Very Preterm Infants Using Speckle Tracking Analysis

Cited by 28 publications

References 34 publications

Maturational Patterns of Systolic Ventricular Deformation Mechanics by Two-Dimensional Speckle-Tracking Echocardiography in Preterm Infants over the First Year of Age

Maturational Patterns of Systolic Ventricular Deformation Mechanics by Two-Dimensional Speckle-Tracking Echocardiography in Preterm Infants over the First Year of Age

Novel Echocardiography Methods in the Functional Assessment of the Newborn Heart

Does chest wall conformation influence myocardial strain parameters in infants with pectus excavatum?

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