Left ventricular ejection fraction using manual and semi‐automated biplane method of discs in very preterm infants

Abstract

Background Biplane left ventricular ejection fraction (LVEF) is a valuable echocardiographic parameter for assessment of LV systolic pump efficiency in adults and children, but not often reported in preterm infants. The primary aim of this study was to longitudinally measure biplane LVEF in very preterm infants during the neonatal intensive care period. Secondary aim was to compare manual and semi‐automatic determination of LVEF for agreement and variability. Methods Stable preterm infants less than 30 weeks gestation were scanned on day 3, day 28, and at 36 weeks postmenstrual age. The LV endocardium was traced manually and semi‐automatically using integrated speckle tracking software in apical 4‐chamber and apical 3‐chamber images to obtain end‐diastolic volume and end‐systolic volume, and calculate LVEF. Agreement between methods and variability within and between observers was determined using an interclass correlation coefficient (ICC) and Bland‐Altman analysis. Results Sixty‐six preterm infants with a mean birth weight of 1100 (239) g were analyzed. The average manual biplane LVEF was 58 (3)%, 59 (3)%, and 55 (4)% at the three respective time points. Manual LVEF showed good agreement with semi‐automatic LVEF (ICC 0.76) with a small bias of −1.5 (3.0)%. Interobserver variability of LVEF improved with semi‐automatic tracing of the LV endocardial border (ICC manual 0.68 vs semi‐automatic 0.80). Conclusion Left ventricular systolic pump efficiency in preterm infants remains stable during the neonatal intensive care period. Semi‐automatic biplane LVEF has less interobserver variability and can be used interchangeably with manual biplane LVEF.

The association between patterns of early respiratory disease and diastolic dysfunction in preterm infants

“…There were no significant differences at the first or second cardiac scan in sodium, lactate, pH, pCO 2 and base excess between the groups. Hemoglobin was significantly lower in the RD and EPRD groups at first scan (126 (19) and 132 (30) versus 147 (22) gr/L, p < 0.01) and at the second scan (98 (17) and 101 (16) versus 115 (18) gr/L, p < 0.01).…”

“…The first cardiac ultrasound scan was performed at a median of 7 (5-8) days after birth, and the second scan at 18 (15)(16)(17)(18)(19)(20) days. Figure 1 shows the prevalence of diastolic dysfunction in relation to respiratory patterns, and Fig.…”

Echocardiography algorithms to assess high left atrial pressure and grade diastolic function in preterm infants

“…Pulse wave and Tissue Doppler parameters were taken with a sample volume of 1.5 and 200 mm/sec sweep speed and reported as an average of measurements from three to five cardiac cycles. Detailed methodology of the used ultrasound parameters is presented in Figures 1–6 And Supplemental Table 1 11–18 . Our protocol did not include pulmonary vein Doppler or LV torsion measurements.…”

Comprehensive Metabolomic Profiling of Cord Blood and Placental Tissue in Surviving Monochorionic Twins Complicated by Twin-Twin Transfusion Syndrome With or Without Fetoscopic Laser Coagulation Surgery: A Retrospective Cohort Study

“…The echocardiographic monitoring of newborns in this study was performed within 2 days of birth and conducted according to previous studies and published clinical guidelines ( Mertens et al, 2011 ; Tissot et al, 2018 ; Phad and Waal, 2020 ) by several experienced ultrasound specialists. LV endocardial tracing was performed semiautomatically using speckle tracking software.…”