Two-dimensional Doppler echocardiographic assessment of closure of the ductus arteriosus in normal newborn infants

Hiraishi, Satoshi; Misawa, Hitoshi; Oguchi, Kouki; Kadoi, Nobuaki; Saito, Ko; Fujino, Nobuyuki; Hojo, Midori; Horiguchi, Y; Yashiro, Kimio

doi:10.1016/s0022-3476(87)80263-9

Cited by 26 publications

(10 citation statements)

References 10 publications

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“…In our study , and in that of Agata et al (2), the AO flow velocity-time integral was at the highest level at 2 h of age. As previously documented (9,20), our study has shown that the ductus arteriosus remained widely patent shortly after birth with a predominant left-to-right shunting. This shunt is likely to playa major role in the increased AO flow velocity-time integral at 2 h of age.…”

supporting

confidence: 82%

“…The inner diameter was measured at the narrowest portion of the ductal lumen in the parasternal long-axis plane. As suggestedby Hiraishi et al (9,10), we also judged that the ductus arteriosus was closing when the narrowest diameter was less than 2 mm or non phasic continuous low-velocity flow was recorded upstream of the narrowing portion of the ductus arteriosus. It was considered closed when the color image and shunt flow were no longer detectable .…”

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confidence: 99%

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Doppler Echocardiographic Evaluation of Left Ventricular Output and Left Ventricular Diastolic Filling Changes in the First Day of Life

et al. 1994

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MATERIALS AND METHODSThe loading condition of the left ventricle changes markedly during the transition from fetal to neonatal circulation and continues to be unstable shortly after birth. During this period, pulmonary blood flow, which acts as preload to the left ventricle, increases because of left-to-right ductus arteriosus shunting (I, 2). Among the hemodynamic factors affecting left ventricular diastolic filling, preload appears to play an important role, as has been recently suggested (3,4). Interest has more recently been directed toward the possibility of using Doppler echocardiography to assess left ventricular diastolic hemodynamics in the early neonatal period (5-8). However, the impact of changes in preload on the transmitral flow pattern in neonates is as yet unclear. The purpose of our study was to evaluate by Doppler echocardiography the serial changes of left ventricular filling patterns in normal neonates during their transition to postnatal circulation.Study population. The study population consisted of20 normal term neonates. Their mothers had uncomplicated pregnancies with no evidence of toxemia, diabetes mellitus, or pregnancyinduced hypertension. None of the infants were acutely ill or showed any evidence of congenital malformations. The mean birth weight was 3068 ± 351 g (mean ± SD), and the mean gestational age was 39 ± I wk. Each mother received an explanation of the study and gave informed consent. Serial echocardiographic examinations were performed on each subject at 2, 12, and 24 h after birth.Examination technique. A complete two-dimensional echocardiographic examination was performed on the subjects with an Aloka SSD 870 ultrasonoscope with a 5.0-MHz transducer. The size of the Doppler sample volume was set at an axial length of 2 mm, with a wall filter setting of 400 Hz. All neonates were examined while they were lying quietly in the supine position breathing room air. To record the transmitral flow velocity profile, a standard apical two-chamber view was visualized, and the Doppler sample volume was placed in the inflow area of the left ventricle just below the level of the mitral annulus, adjusted to record the maximal flow velocities. The ascending aortic flow was measured from the suprasternal long axis view. The sample volume was placed in the AO immediately distal to the aortic valve. Care was taken to carry out these studies with the transducer beam as close to parallel to the presumed blood flow direction as possible. Because the angle between the estimated direction of blood flow and the Doppler beam was 20 degrees or less in the selected planes, no angle correction of the Doppler signal was made. All examinations were recorded at a paper speed of 100 mm/s, The electrocardiogram and respiration of each subject (with a pressure transducer placed against the abdominal wall) were simultaneously recorded. With the aid of a computer-interfaced digitizer pad (Cardio 500, Kontron Medical System), the various Doppler flow indices were measured from 506 Abbreviations AD, ascendin...

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confidence: 99%

Doppler Echocardiographic Evaluation of Left Ventricular Output and Left Ventricular Diastolic Filling Changes in the First Day of Life

et al. 1994

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“…Ductal constriction however, has been observed as early as 4 h after birth in around 80% of the normal neonates [39]. In the present study, CI showed a significant fall within the first 8 h of life.…”

Section: Patent Ductus Arteriosus (Pda)contrasting

confidence: 56%

Measurement of systemic oxygen delivery and inotropy in healthy term neonates with the Ultrasonic Cardiac Output Monitor (USCOM)

Sun

Zhang

et al. 2013

Early Human Development

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“…It seems reasonable to assume that the echogenic tissue protruding locally into the ductal lumen represents increased intimal and subintimal 'cushions', known from the morphological matura tion stages of ductal closure [ 15,26], or localized constric tion. Similar sonographic findings have been described during physiological closure after birth [27], In accor dance with the narrowed lumen, the systolic flow velocity was markedly increased in the distal ductal part. In con trast to the typical finding of increased diastolic ductal velocities in indomethacin-induced general constriction of the entire ductus, associated with other vascular effects of indomethacin, including alterations in pulmonary vas cular resistance and pulmonary arterial hypertension [19,22], in the present case diastolic velocities were not increased, possibly due to only partial ductal obstruction and absence of pulmonary arterial hypertension.…”

Section: Discussionsupporting

confidence: 85%

Prenatal Diagnosis of Idopathic Stenosis of the Ductus arteriosus Associated with Fetal Atrial Flutter

Mielke

Steil²,

Gonser³

1997

Fetal Diagn Ther

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Antenatal stenosis or closure of the ductus arteriosus unrelated to either congenital heart defects or prostaglandin inhibitors is considered to be uncommon, but may result in congestive heart failure, hydrops fetalis, and perinatal death. We report a case of idiopathic ductal stenosis detected prenatally by two-dimensional and Doppler echocardiography in a fetus presenting atrial flutter and right atrial dilatation at 31 weeks of gestation. Prenatal treatment with digoxin and verapamil resulted in conversion to sinus rhythm. The fetus was closely monitored. Congestive heart failure did not develop, and the fetus was delivered spontaneously in good condition at 39 weeks of gestation. In case of ductal stenosis, the potential risk of congestive heart failure must be considered, and maternal administration of drugs with constrictive effects on the ductus arteriosus, as indomethacin or betamethasone, should be avoided.

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Two-dimensional Doppler echocardiographic assessment of closure of the ductus arteriosus in normal newborn infants

Cited by 26 publications

References 10 publications

Doppler Echocardiographic Evaluation of Left Ventricular Output and Left Ventricular Diastolic Filling Changes in the First Day of Life

Doppler Echocardiographic Evaluation of Left Ventricular Output and Left Ventricular Diastolic Filling Changes in the First Day of Life

Measurement of systemic oxygen delivery and inotropy in healthy term neonates with the Ultrasonic Cardiac Output Monitor (USCOM)

Prenatal Diagnosis of Idopathic Stenosis of the Ductus arteriosus Associated with Fetal Atrial Flutter

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