Evolution of Left Ventricular Function in the Preterm Infant

Hirose, Akiko; Khoo, Nee Scze; Aziz, Khalid; Al-Rajaa, Najlaa; Boom, Jutta van den; Savard, Winnie; Brooks, Paul; Hornberger, Lisa K.

doi:10.1016/j.echo.2014.10.017

Cited by 61 publications

(63 citation statements)

References 39 publications

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“…Schubert et al also found no significant associations between the speckle-tracking outcome variables at three months of corrected age and the diagnosis of PDA. 16 We suspect that the effects of a PDA on LV strain imaging during the transition period and early neonatal period that has been observed in previous studies, may either dissipate over time, 35,38 may be more of a true reflection in myocardial diastolic performance, 13 or are unlikely to be due solely to the presence of PDA. 14 The importance of these findings is that they support the notion that most premature neonates who fail to close their PDA after the first week of age may likely not experience significant cardiac morbidity as evidence by similar LV and RV strain patterns.…”

Section: Discussionmentioning

confidence: 79%

“…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). 13 Schubert et al observed that in a small heterogeneous cohort of 25 preterm infants (16% had BPD, and 40% had septicemia), and 30 term infants that there was relatively uniform LV strain values from birth to six month of age. 16 These results coincide with the findings of Helfer and Czernik 38 and James et al 11,22 whose groups used tissue Doppler-derived strain imaging to demonstrate relative stability in LV strain imaging in preterm infants from birth through 28 days and 36 weeks PMA, respectively.…”

Section: Discussionmentioning

confidence: 99%

“…7,8,11–14 However, the evolution of ventricular strain mechanics from birth to one year of age for clinical application has not been comprehensively described in a large longitudinal preterm cohort. 13,15 Disturbances in myocardial function may also impact neonatal morbidity and mortality, but there is limited information on how different prematurity associated cardiopulmonary conditions, such as bronchopulmonary dysplasia (BPD), pulmonary hypertension (PH), and a persistent patent ductus arteriosus (PDA), influence the normal changes in longitudinal cardiac function. 16 …”

Section: Introductionmentioning

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: 79%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

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

View full text Add to dashboard Cite

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“…In an animal model of preterm birth—delivering healthy pregnant sheep before they reached full‐term gestation—cardiomyocyte hypertrophy and collagen deposition were observed in the offspring as early as 9 weeks after term‐equivalent age 21. In human studies, altered myocardial function seems to precede structural changes and has been reported weeks and months after preterm birth 19, 22, 23. These observations suggest that the triggering events are birth related.…”

Section: Discussionmentioning

confidence: 97%

The Preterm Heart in Childhood: Left Ventricular Structure, Geometry, and Function Assessed by Echocardiography in 6‐Year‐Old Survivors of Periviable Births

Mohlkert

Hallberg

Broberg

et al. 2018

JAHA

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BackgroundPreterm birth has been associated with increased risk of cardiovascular morbidity in adult life. We evaluated whether preterm birth is associated with deviating cardiac structure and function before school start.Methods and ResultsIn total, 176 children aged 6 years and born extremely preterm (EXPT; gestational age of 22–26 weeks) and 134 children born at term (control [CTRL]) were studied. We used echocardiography to assess left heart dimensions, geometry, and functions. Recording and off‐line analyses of echocardiographic images were performed by operators blinded to group belonging. Body size, blood pressure, and heart rate were also measured. Rates of family history of cardiovascular disease and sex distribution were similar in the EXPT and CTRL groups. Heart rate and systolic blood pressure did not differ, whereas diastolic blood pressure was slightly higher in EXPT than CTRL participants. After adjusting for body surface area, left ventricular length, width, and aortic valve annulus diameter were 3% to 5% smaller in EXPT than CTRL participants. Left ventricular longitudinal shortening and systolic tissue velocity were 7% to 11% lower, and transversal shortening fraction was 6% higher in EXPT than CTRL participants. The EXPT group also exhibited lower atrial emptying velocities than the CTRL group. Sex, fetal growth restriction, or a patent ductus arteriosus in the neonatal period did not contribute to cardiac dimensions or performance.ConclusionsSix‐year‐old children born extremely preterm exhibit a unique cardiac phenotype characterized by smaller left ventricles with altered systolic and diastolic functions than same‐aged children born at term.

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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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Evolution of Left Ventricular Function in the Preterm Infant

Cited by 61 publications

References 39 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

The Preterm Heart in Childhood: Left Ventricular Structure, Geometry, and Function Assessed by Echocardiography in 6‐Year‐Old Survivors of Periviable Births

Novel Echocardiography Methods in the Functional Assessment of the Newborn Heart

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