Reference Values for Point-of-Care Echocardiographic Measurements of Preterm Infants in China

Lu, Danfang; Tong, Xiao-Mei; Liu, Yunfeng; Zhang, Hua

doi:10.3389/fped.2022.894152

Cited by 4 publications

(3 citation statements)

References 36 publications

(47 reference statements)

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“…All available echocardiographic data at baseline (prior to start of levosimendan administration) and at follow-up (24 h after onset of levosimendan administration) were retrospectively evaluated offline for analysis independently by two experienced neonatal echocardiographers blinded for the course of the respective infant. Ventricular dysfunction was defined as (a) right ventricular dysfunction (RVD), (b) For the assessment of ventricular dysfunction, a combined approach of quantitative and qualitative measurements was used, based on international guidelines for neonatal echocardiography [12,14,23]. In all patients, stored loops (3-5 s) visualizing the ventricular function (both 4-chamber view and parasternal long-axis) were interpreted via eyeballing assessment [23,25].…”

Section: Echocardiographic Measurementsmentioning

confidence: 99%

Evaluation of levosimendan as treatment option in a large case-series of preterm infants with cardiac dysfunction and pulmonary hypertension

et al. 2023

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Levosimendan as a calcium-sensitizer is a promising innovative therapeutical option for the treatment of severe cardiac dysfunction (CD) and pulmonary hypertension (PH) in preterm infants, but no data are available analyzing levosimendan in cohorts of preterm infants. The design/setting of the evaluation is in a large case-series of preterm infants with CD and PH. Data of all preterm infants (gestational age (GA) < 37 weeks) with levosimendan treatment and CD and/or PH in the echocardiographic assessment between 01/2018 and 06/2021 were screened for analysis. The primary clinical endpoint was defined as echocardiographic response to levosimendan. Preterm infants (105) were finally enrolled for further analysis. The preterm infants (48%) were classified as extremely low GA newborns (ELGANs, < 28 weeks of GA) and 73% as very low birth weight infants (< 1500 g, VLBW). The primary endpoint was reached in 71%, without difference regarding GA or BW. The incidence of moderate or severe PH decreased from baseline to follow-up (24 h) in about 30%, with a significant decrease in the responder group (p < 0.001). The incidence of left ventricular dysfunction and bi-ventricular dysfunction decreased significantly from baseline to follow-up (24 h) in the responder-group (p = 0.007, and p < 0.001, respectively). The arterial lactate level decreased significantly from baseline (4.7 mmol/l) to 12 h (3.6 mmol/l, p < 0.05), and 24 h (3.1 mmol/l, p < 0.01). Conclusion: Levosimendan treatment is associated with an improvement of both CD and PH in preterm infants, with a stabilization of the mean arterial pressure during the treatment and a significant decrease of arterial lactate levels. Future prospective trials are highly warranted. What is Known: • Levosimendan as a calcium-sensitizer and inodilator is known to improve the low cardiac output syndrome (LCOS), and improves ventricular dysfunction, and PH, both in pediatric as well as in adult populations. Data related to critically ill neonates without major cardiac surgery and preterm infants are not available. What is New: • This study evaluated the effect of levosimendan on hemodynamics, clinical scores, echocardiographic severity parameters, and arterial lactate levels in a case-series of 105 preterm infants for the first time. Levosimendan treatment in preterm infants is associated with a rapid improvement of CD and PH, an increase of the mean arterial pressure, and a significant decrease in arterial lactate levels, as surrogate marker for a LCOS. • How this study might affect research, practice, or policy. As no data are available regarding the use of levosimendan in this population, our results hopefully animate the research community to conduct future prospective trails analyzing levosimendan in randomized controlled trials (RCT) and observational control studies. Additionally, our results potentially motivate clinicians to introduce levosimendan as second second-line therapy in cases of severe CD and PH in preterm infants without improvement using standard treatment strategies.

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Section: Echocardiographic Measurementsmentioning

confidence: 99%

Evaluation of levosimendan as treatment option in a large case-series of preterm infants with cardiac dysfunction and pulmonary hypertension

et al. 2023

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“…AHF was de ned as ventricular dysfunction (a) right-ventricular dysfunction (RVD), b) left-ventricular dysfunction (LVD), and c) biventricular dysfunction (BVD) and classi ed as: present or not present. For the assessment of ventricular dysfunction a combined approach of quantitative and qualitative measurements was used, based on international guidelines for neonatal echocardiography [15,24,13]. PH was graded as mild, moderate, or severe, using the following echocardiographic parameters: a) PDA ow pattern b) intraventricular septum position, and c) tricuspid valve regurgitation.…”

Section: Echocardiographic Assessmentmentioning

confidence: 99%

Evaluation of levosimendan as treatment option in preterm infants with cardiac dysfunction and pulmonary hypertension

Schroeder

Holcher

Leyens

et al. 2023

Preprint

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Objectives Levosimendan as a calcium-sensitizer is a promising innovative therapeutical option for the treatment of severe cardiac dysfunction (CD) and pulmonary hypertension (PH) in preterm infants, but no data are available analyzing levosimendan in cohorts of preterm infants. Design/ Setting Retrospective single-center cohort study. Patients and Methods Retrospective single-center cohort study. Data of all preterm infants (gestational age (GA) <37 weeks) with levosimendan treatment and CD and/or PH in the echocardiographic assessment between 01/2018 and 06/2021 were screened for analysis. Main outcome measures The primary clinical endpoint was defined as echocardiographic response to levosimendan. Results 105 preterm infants were finally enrolled for further analysis. 48% of the preterm infants were classified as extremely low for GA newborns (ELGANs, <28 weeks of GA) and 73% as extremely low birth weight infants (<1500g, ELBW). The primary endpoint was reached in 71%, without difference regarding GA or BW. The incidence of moderate or severe PH decreased from baseline to follow-up (24h) in about 30%, with a significant decrease in the Responder-group (p<0.001). The incidence of left-ventricular dysfunction and bi-ventricular dysfunction decreased significantly from baseline to follow-up (24h) in the Responder-group (p=0.007, and p<0.001, respectively). The arterial lactate level decreased significantly from baseline (4.7 mmol/l) to 12h (3.6 mmol/l, p<0.05), and 24h (3.1 mmol/l, p<0.01). Conclusion Levosimendan treatment is associated with an improvement of both CD and PH in preterm infants, with a stabilization of the MAP during the treatment and a significant decrease of arterial lactate levels. Future prospective trials are highly warranted.

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“…especially in premature infant. [6][7][8] Many perinatal events such as antenatal steroid use, maternal diabetes, can affect cardiac size. 9 In addition, dexamethasone, which can cause ventricular hypertrophy, is usually given to preterm infants during the early neonatal life to prevent chronic lung diseases.…”

mentioning

confidence: 99%

Percentile curves of normal echocardiographic measurements values for left heart structures in 1570 Han Chinese preterm and term infants

Wang

et al. 2022

J of Clinical Ultrasound

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Objective: This study was designed to evaluate echocardiographic measurements in Han Chinese preterm and term infants and to build percentile curves of normal echocardiographic measurements values related to the weight. Method: From December 2014 to December 2021, a total of 797 male infants and 773 female infants born in * were included in the study. The echocardiographic measurements of each subject were as follows: left ventricular internal diameter at end-diastole (LVIDd), left ventricular internal diameter at end-systole (LVIDs), left ventricular posterior wall thickness at end-diastole (LVPWd), left ventricular posterior wall thickness at end-systole (LVPWs), interventricular septal thickness at enddiastole (IVSd), interventricular septal thickness at end-systole (IVSs), ascending aorta diameter (AO), left atrium (LA) dimension, left ventricular ejection fraction (LVEF), left ventricular fractional shortening (LVFS) and left ventricular mass (LVM). The correlations between echocardiography measurements and birth weight (BW), length (L), gestational age (GA), and body surface area (BSA) were analyzed. Results: There was a good correlation between the echocardiographic measurements and birth weight and percentile curves of the echocardiographic measurements were established according to different birth weight. The echocardiographic measurements were not affected by gender. However, LVEF and LVFS did not change with BW or gender. Conclusions: The percentile curves of normal values make it possible to classify echocardiographic measurements for left heart structures and function as normal or abnormal and is helpful for the diagnosis of neonatal heart disease in preterm and term infants.

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Reference Values for Point-of-Care Echocardiographic Measurements of Preterm Infants in China

Cited by 4 publications

References 36 publications

Evaluation of levosimendan as treatment option in a large case-series of preterm infants with cardiac dysfunction and pulmonary hypertension

Evaluation of levosimendan as treatment option in a large case-series of preterm infants with cardiac dysfunction and pulmonary hypertension

Evaluation of levosimendan as treatment option in preterm infants with cardiac dysfunction and pulmonary hypertension

Percentile curves of normal echocardiographic measurements values for left heart structures in 1570 Han Chinese preterm and term infants

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