Early modifications of cardiac function in preterm neonates using speckle tracking echocardiography

Castaldi, Biagio; Bordin, Giulia; Favero, Valentina; Nardo, Daniel; Previati, Francesca; Salvadori, Severo; Baraldi, Eugenio; Milanesi, Ornella

doi:10.1111/echo.13853

Cited by 10 publications

(10 citation statements)

References 20 publications

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“…The higher indices of twist and torsion seen in the premature population are due to the change in basal rotation from an anticlockwise to clockwise motion. This was also reported in preterm infants by Castaldi et al 21 This concept is further reinforced with the strong positive correlation between LV torsion and untwist rate in the entire cohort during the third scan in this study. The adaptive response of LV twist in our premature cohort most likely evolved due to diminished longitudinal function and not consequent to any interplay with pulmonary haemodynamics, since the relative indices of PVR were equivalent between preterm and term babies.…”

Section: Summary Of Findingssupporting

confidence: 91%

Comparison of left ventricular rotational mechanics between term and extremely premature infants over the first week of age

et al. 2021

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ObjectiveLeft ventricle (LV) rotational mechanics is an emerging tool to characterise LV function, but warrants further evaluation in neonates. The aim of this study was to compare LV rotational mechanics between term and extremely preterm babies over the first week of age.MethodsIn this prospective study, we serially assessed LV rotational parameters in 50 term infants and compared them with a historical dataset of 50 preterm infants born <29 weeks gestation. LV basal and apical rotation, LV twist, LV twist/untwist rate and torsion were derived using two-dimensional speckle tracking echocardiography at three time points over the first week of age.ResultsThere was no change in LV twist, LV torsion, basal rotation or apical rotation in term infants over the study period (all p>0.05). LV twist and torsion were higher in preterm infants, and increased over time. In preterm infants, basal rotation evolved from anticlockwise to clockwise rotation. Apical rotation remained anticlockwise in both groups (all p>0.05). LV twist rate (LVTR) and untwist rate was higher in preterm infants and increased over the three time points (all p>0.05). There was a strong positive correlation between LV torsion and LV untwist rate (LVUTR) in the entire cohort during the third scan.ConclusionTerm infants exhibit minimal LV twist which remains unchanged over the first week of age. This is in contrast to premature infants who demonstrate increasing indices of twist, torsion, LVTR and LVUTR over the first week, likely as a compensatory mechanism for reduced LV compliance.

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Section: Summary Of Findingssupporting

confidence: 91%

Comparison of left ventricular rotational mechanics between term and extremely premature infants over the first week of age

et al. 2021

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“…Recent echocardiographic, magnetic resonance and CT imaging studies indicate that preterm infants have larger left atria and lower diastolic function than term infants (14)(15)(16)(17), suggesting that the heart failure among young adults who were born preterm has developmental origins. Serum from preterm infants was shown to have higher levels of malonyl-carnitine and lower levels of palmatoylcarnitine than serum from term infants born (62), suggesting a link between preterm birth and reduced FASN activity.…”

Section: Discussionmentioning

confidence: 99%

“…While prior studies have reported a loss of pulmonary capillaries, altered ventricular shape and decreased aortic size in young adults born preterm (9)(10)(11)(12)(13), the root causes of pulmonary hypertension, heart failure and other cardiovascular diseases in the survivors of preterm birth remain poorly understood. Recent echocardiographic, magnetic resonance, and CT imaging studies indicate that preterm infants have larger left atria and lower diastolic function than term infants (14)(15)(16)(17). These changes may be an early and direct response to oxygen exposure because diastolic heart failure has been seen in preterm infants on supplemental oxygen therapies (18).…”

Section: Introductionmentioning

confidence: 99%

Neonatal hyperoxia inhibits proliferation of atrial cardiomyocytes by suppressing fatty acid synthesis

Cohen

Yee

Porter

et al. 2020

Preprint

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Preterm birth increases the risk for pulmonary hypertension and heart failure in adulthood.Oxygen therapy can damage the immature cardiopulmonary system and may be partially responsible for the cardiovascular disease in adults born preterm. We previously showed that exposing newborn mice to hyperoxia causes pulmonary hypertension by 1 year of age that is preceded by a poorly understood loss of pulmonary vein cardiomyocyte proliferation. We now show that hyperoxia also inhibits the proliferation of left atrial cardiomyocytes and causes diastolic heart failure by thinning the walls of the left atrium and disrupting its ability to pump effectively. Transcriptomic profiling showed that neonatal hyperoxia permanently suppressed fatty acid synthase (Fasn), stearoyl-CoA desaturase 1 (Scd1) and other fatty acid synthesis genes in the atria of mice, the HL-1 line of mouse atrial cardiomyocytes and left atrial tissue explanted from human infants. Suppressing Fasn or Scd1 reduced HL-1 cell proliferation while overexpressing these genes maintained their expansion in hyperoxic conditions, suggesting hyperoxia directly inhibits atrial cardiomyocyte proliferation by repressing Fasn and Scd1. Pharmacologic interventions that restore Fasn, Scd1 and other fatty acid synthesis genes in atrial cardiomyocytes may thus provide a way of ameliorating the adverse effects of supplemental oxygen on preterm infants.

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“…While prior studies have reported a loss of pulmonary capillaries, altered ventricular shape, and decreased aortic size in young adults born preterm (9)(10)(11)(12)(13), the root causes of pulmonary hypertension, heart failure, and other cardiovascular diseases in the survivors of preterm birth remain poorly understood. Recent echocardiographic imaging, MRI, and CT imaging studies indicate that preterm infants have larger left atria and lower diastolic function than term infants (14)(15)(16)(17). These changes may be an early and direct response to oxygen exposure because diastolic heart failure has been seen in preterm infants on supplemental oxygen therapies (18).…”

Section: Introductionmentioning

confidence: 99%

Neonatal hyperoxia inhibits proliferation and survival of atrial cardiomyocytes by suppressing fatty acid synthesis

Cohen¹,

Yee²,

Porter³

et al. 2021

JCI Insight

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Preterm birth increases the risk for pulmonary hypertension and heart failure in adulthood. Oxygen therapy can damage the immature cardiopulmonary system and may be partially responsible for the cardiovascular disease in adults born preterm. We previously showed that exposing newborn mice to hyperoxia causes pulmonary hypertension by 1 year of age that is preceded by a poorly understood loss of pulmonary vein cardiomyocyte proliferation. We now show that hyperoxia also reduces cardiomyocyte proliferation and survival in the left atrium and causes diastolic heart failure by disrupting its filling of the left ventricle. Transcriptomic profiling showed that neonatal hyperoxia permanently suppressed fatty acid synthase ( Fasn ), stearoyl-CoA desaturase 1 ( Scd1 ), and other fatty acid synthesis genes in the atria of mice, the HL-1 line of mouse atrial cardiomyocytes, and left atrial tissue explanted from human infants. Suppressing Fasn or Scd1 reduced HL-1 cell proliferation and increased cell death, while overexpressing these genes maintained their expansion in hyperoxia, suggesting that oxygen directly inhibits atrial cardiomyocyte proliferation and survival by repressing Fasn and Scd1 . Pharmacologic interventions that restore Fasn , Scd1 , and other fatty acid synthesis genes in atrial cardiomyocytes may, thus, provide a way of ameliorating the adverse effects of supplemental oxygen on preterm infants.

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Early modifications of cardiac function in preterm neonates using speckle tracking echocardiography

Abstract: Echocardiographic assessment of myocardial deformation parameters is feasible in preterm infants. Our data suggest that the maturational process of the myocardium is due to the development of the epicardial layer after birth, which allows the acquisition of the twist.

Cited by 10 publications

References 20 publications

Comparison of left ventricular rotational mechanics between term and extremely premature infants over the first week of age

Comparison of left ventricular rotational mechanics between term and extremely premature infants over the first week of age

Neonatal hyperoxia inhibits proliferation of atrial cardiomyocytes by suppressing fatty acid synthesis

Neonatal hyperoxia inhibits proliferation and survival of atrial cardiomyocytes by suppressing fatty acid synthesis

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