Right Atrial Strain in Preterm Infants With a History of Bronchopulmonary Dysplasia

Abstract

BACKGROUND Few studies have utilized right atrial (RA) strain to evaluate right ventricular (RV) diastolic dysfunction in preterm infants with bronchopulmonary dysplasia (BPD). We aimed to evaluate the associations of RA strain with BPD severity and respiratory outcomes in preterm infants with BPD. METHODS We retrospectively studied 153 infants with BPD born before 32 weeks of gestational age at CHA Bundang Medical Center. Peak longitudinal right atrial strain (PLRAS) was obtained using velocity vector imaging and compared among infants across BPD severity. Conventional echocardiographic parameters and clinical characteristics were also evaluated. RESULTS In infants with severe BPD, mean gestational age (27.4 ± 2.1 weeks) and mean birth weight (971.3 ± 305.8 g) were significantly smaller than in those with mild BPD (30.0 ± 0.9 weeks, 1,237.3 ± 132.2 g) and moderate BPD (29.6 ± 1.3 weeks, 1,203.2 ± 214.4 g). PLRAS was significantly lower in infants with severe BPD (26.3 ± 10.1%) than in those in the moderate BPD group (32.4 ± 10.9%) or mild BPD group (31.9 ± 8.3%). Tricuspid E/e′ and maximum RA volume index were similar across BPD severity. A decrease in PLRAS was significantly correlated with increased duration of mechanical ventilation duration; however, tricuspid E/e′ and maximum RA volume index were not. CONCLUSIONS Evaluating PLRAS with other parameters in infants with BPD might detect RV diastolic dysfunction. Longer follow-up and larger study populations may elucidate the association between PLRAS and respiratory outcomes in infants with BPD.

Right Atrial Mechanics on Speckle-Tracking Echocardiography: Clinical Implications in Children

“…For the assessment of RA mechanics, strain imaging using speckle tracking echocardiography has emerged as a promising new tool. The current study by Kang et al 2) represents one effort to apply strain imaging in the evaluation of right-sided heart dysfunction in children. They focused on potential of peak longitudinal RA strain measured by speckle-tracking echocardiography as an RV functional index in preterm infants with bronchopulmonary dysplasia.…”