Does echocardiography facilitate determination of hemodynamic significance attributable to the ductus arteriosus?

Abstract

In this review, we will highlight the evidence for echocardiography markers of hemodynamic significance and speculate as to how they may facilitate improved decision making in the neonatal intensive care unit.

Can Early B-Type Natriuretic Peptide Assays Predict Symptomatic Patent Ductus Arteriosus in Extremely Low Birth Weight Infants?

“…Sehgal et al [5] found that echocardiographic markers have low sensitivity and specificity with regard to ductal significance in isolation [4] and concluded that a more comprehensive echocardiographic evaluation is needed for more accurate decision making in infants with an hsPDA. However, a comprehensive echocardiographic evaluation by skilled clinicians is difficult to be performed frequently in developing country and could make these tiny infants unstable.…”

Quantitative, Noninvasive Assessment of Patent Ductus Arteriosus Shunt Flow by Measuring Proximal Isovelocity Surface Area on Color Doppler Imaging

“…Several parameters have previously been described by echocardiography for classification of PDA, including in the neonatal field. 18 LA/ AO derived using M-mode imaging from the long-axis approach is the most well-recognized surrogate of the severity of PDA and was first described by Silverman et al in 1974. 19 However, many of these markers have low sensitivity and specificity for ductal significance when compared with PDA diameter, because the diameter of the PDA can not be demonstrated accurately, as is often the case.…”

Learning to live with patency of the ductus arteriosus in preterm infants

“…A staging system incorporating clinical and echocardiographic findings has been proposed by McNamara and Sehgal, 71 who have critically reviewed the use of echocardiographic measurements to quantify the hemodynamic significance of PDA. 72 El-Kuffash et al 73 have found elevated serum levels of N-terminal pro-B-type natriuretic peptide and cardiac troponin T at 48 h of age in preterm infants with PDA and grade III/IV IVH or death, as compared with infants with PDA without those complications or those with a closed ductus. Those authors did not find differences in echocardiographic measurements of PDA size, left atrial to aortic ratio or left and right ventricular outputs between the PDA groups with and without complications.…”