- Title
- Post-transitional adaptation of the left heart in uncomplicated, very preterm infants
- Creator
- de Waal, Koert; Phad, Nilkant; Lakkundi, Anil; Tan, Peter
- Relation
- Cardiology in the Young Vol. 27, Issue 6, p. 1167-1173
- Publisher Link
- http://dx.doi.org/10.1017/S1047951116002687
- Publisher
- Cambridge University Press
- Resource Type
- journal article
- Date
- 2017
- Description
- Background: The postnatal period in preterm infants involves multiple physiological changes occurring immediately after birth and continuing for days or weeks. To recognise and treat compromise, it is important to measure cardiovascular function. The aim of this study was to describe longitudinal left ventricular function using conventional and novel echocardiography techniques in preterm infants who did not experience significant antenatal or postnatal complications and treatments. Methods: We prospectively obtained cardiac ultrasound images at days 3, 7, 14, 21, and 28 in 25 uncomplicated, preterm infants < 30 weeks of gestation. Speckle tracking analysis of the four chambers and short-axis images provided parameters of left ventricular volume, deformation, and basal myocardial velocities. The patent ductus arteriosus, cardiac dimensions, and atrial volume were also measured. Results: Stroke volume increased by 24% during the study period (1.05-1.30 ml/kg, p < 0.05). Cardiac length, diameter, and systolic basal myocardial velocity increased with unchanged wall stress and deformation parameters. Diastolic function parameters resembled that of the fetus with predominance of atrial contraction compared with early diastolic velocities. Blood pressure and estimates of left ventricular filing pressure increased, suggesting that left ventricular compliance did not change in this period. Conclusion: Stroke volume increased in the first 28 days after preterm birth. The preterm heart adapted by increasing its size, while maintaining systolic and atrial function, independent of early diastolic maturation. Longitudinal deformation of the left ventricle remained unchanged, suggesting relatively preserved function with maturation.
- Subject
- speckle tracking echocardiography; preterm infant; reference values; left ventricular function
- Identifier
- http://hdl.handle.net/1959.13/1353189
- Identifier
- uon:31061
- Identifier
- ISSN:1047-9511
- Rights
- This article has been published in a revised form in Cardiology in the Young http://dx.doi.org/10.1017/S1047951116002687. This version is free to view and download for private research and study only. Not for re-distribution, re-sale or use in derivative works. © Cambridge University Press 2017.
- Language
- eng
- Full Text
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