Ventricular systolic time intervals by simultaneous echocardiographic recording of the semilunar valves during the first days of life: A study of normal newborn infants

Yoshida, Yoshiro; Bg, Baylen; Gc, Emmanouilides

doi:10.1002/jcu.1870110805

Cited by 4 publications

(2 citation statements)

References 23 publications

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“…Although we did not perform fetal cardiac function studies, our observation suggests that the later stages of prenatal cardiac dysfunction have a greater impact on neonatal circulatory transition and that cardiovascular instability may be responsible for over 30% of neonatal mortality. Since neonatal cardiovascular instability may result from myocardial dysfunction, the effects of persistent fetal circulation, impacts of mechanical ventilation clarification of these relationships may become important in modifying early neonatal management [31,32,33]. …”

Section: Discussionmentioning

confidence: 99%

Cardiovascular Transition to Extrauterine Life in Growth-Restricted Neonates: Relationship with Prenatal Doppler Findings

Turan¹,

Turan²,

Salim

et al. 2012

Fetal Diagn Ther

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Objective: Cardiovascular status in fetal growth restriction (FGR) can be classified by the severity of individual Doppler abnormalities (early and late) or by the rate of clinical progression. We tested the hypothesis that aspects of the fetal cardiovascular status in FGR affect neonatal cardiovascular findings. Study Design: FGR cases [abdominal circumference <5th percentile and an elevated umbilical (MCA) artery (UA) pulsatility index] had UA, middle cerebral artery and ductus venosus (DV) Doppler. Positive UA end-diastolic velocity and/or a low MCA pulsatility index denoted early and absent/reversed UA end-diastolic velocity, whereas an increased DV pulsatility index for veins denoted late responses. The rate of progression was classified into mild, progressive and severe. After delivery, shunt dynamics and blood flow across the patent ductus arteriosus (PDA), foramen ovale and atriaventricular valves, myocardial contractility and pharmacologic pressor requirement were noted at neonatal echocardiography. These findings were related to prenatal Doppler parameters. Results: In 94 patients, only individual Doppler parameters related to neonatal echocardiographic findings. Absent/reversed UA DV significantly predicted PDA with right to left shunt (p = 0.016). The pressor need for cardiovascular instability was observed in neonates with abnormal prenatal DV Doppler and with lower birth weights delivered at earlier gestational age (p < 0.0001 for both). Pressor need was significantly related to neonatal death (Nagelkerke R² = 0.35, p = 0.002). Conclusion: A markedly abnormal UA Doppler predisposes growth-restricted neonates to persistence of fetal circulation associated with right to left shunting. Abnormal venous Doppler is a risk factor for cardiovascular instability which in turn significantly contributes to neonatal mortality. Further clarification of the neonatal cardiovascular transition may be helpful in guiding early neonatal assessment and management.

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Section: Discussionmentioning

confidence: 99%

Cardiovascular Transition to Extrauterine Life in Growth-Restricted Neonates: Relationship with Prenatal Doppler Findings

Turan¹,

Turan²,

Salim

et al. 2012

Fetal Diagn Ther

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“…Typical stable inflammation is characterized by the presence of macrophages, CD8+ cells and neutrophils with varying deposition in the upper and lower parts of the respiratory tree and between the lumen and airway wall [1, 13]. It seems that in COPD, the inflammation continues even after the cessation of smoking [14]. …”

Section: Introductionmentioning

confidence: 99%

Decreased Cytokine and Chemokine mRNA Expression in Bronchoalveolar Lavage in Asymptomatic Smoking Subjects

et al. 2008

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Background: Smoking alters the inflammatory cell balance in the airways, often leading to repeated respiratory infections and, eventually, chronic obstructive pulmonary disease (COPD) in susceptible individuals. Objective: It was the aim of this study to evaluate alterations in the airway inflammatory balance caused by chronic cigarette smoke exposure. Methods: We compared results of biopsy and bronchoalveolar lavage (BAL) samples from non-smoking (n = 8) and smoking (n = 5; pack years 25.06 ± 11.75, range 7.13–36.8) subjects without COPD. Results: In BAL samples, we found a significantly higher number of total cells (353 ± 96 million vs. 114 ± 52 million; p = 0.003) and macrophages (331 ± 100 million vs. 84 ± 36 million; p = 0.002) in asymptomatic smoking subjects in comparison with never-smokers. Macrophages correlated negatively with the forced expiratory volume in 1 s as percent of the predicted value (ρ = –0.75, p = 0.003). Of 23 mediators examined, mRNA expression of cytokines interleukin (IL)-6, interferon-γ, tumor necrosis factor-β, IL-13 and chemokines CCL5, CCL3, CCL4 and CCL20 was significantly lowered in BAL cells of smokers compared with never-smokers and was negatively correlated with macrophages and positively correlated with the forced expiratory volume in 1 s as percent of the predicted value. Differential cell counts were similar between smokers and never-smokers in the bronchial biopsies. Conclusion: We conclude that in a susceptible population, smoking suppresses inflammatory defense by inhibiting expression of inflammatory mediators in the airways on a large scale.

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Cardiac adaptation in small for gestational age neonates after prenatal hemodynamic disturbances

Robel-Tillig¹,

Knüpfer²,

Vogtmann³

2003

Early Human Development

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Ventricular systolic time intervals by simultaneous echocardiographic recording of the semilunar valves during the first days of life: A study of normal newborn infants

Cited by 4 publications

References 23 publications

Cardiovascular Transition to Extrauterine Life in Growth-Restricted Neonates: Relationship with Prenatal Doppler Findings

Cardiovascular Transition to Extrauterine Life in Growth-Restricted Neonates: Relationship with Prenatal Doppler Findings

Decreased Cytokine and Chemokine mRNA Expression in Bronchoalveolar Lavage in Asymptomatic Smoking Subjects

Cardiac adaptation in small for gestational age neonates after prenatal hemodynamic disturbances

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