Tissue Doppler imaging in very preterm infants during the first 24 h of life: an observational study

• Published in: Archives of disease in childhood. Fetal and neonatal edition Vol. 99; no. 1; pp. F64 - F69
• Main Authors: Lee, A, Nestaas, E, Liestøl, K, Brunvand, L, Lindemann, R, Fugelseth, D
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group 01.01.2014; BMJ Publishing Group LTD
• Subjects: Biological and medical sciences; Blood Pressure Determination; Cohort Studies; Delivery. Postpartum. Lactation; Diseases of mother, fetus and pregnancy; Ductus Arteriosus, Patent - diagnostic imaging; Echocardiography, Doppler, Color - methods; Female; Gestational Age; Gynecology. Andrology. Obstetrics; Hemodynamics; Humans; Infant; Infant, Extremely Premature; Infant, Newborn; Infant, Premature, Diseases - diagnostic imaging; Infant, Very Low Birth Weight; Infants; Intensive Care Units, Neonatal; Longitudinal Studies; Male; Maternal, fetal and perinatal monitoring; Medical sciences; Myocardium; Norway; Observational studies; Pregnancy. Fetus. Placenta; Premature birth; Prospective Studies; Pulmonary arteries; Studies; Ultrasonic imaging; Velocity; Ventricular Function - physiology; Sonography; Very low birthweight; Premature; Observational study; Newborn diseases; Pregnancy disorders; Prematurity; Premature delivery; Tissue doppler; Neonatology; Cardiology; Circulatory
• ISSN: 1359-2998; 1468-2052
• DOI: 10.1136/archdischild-2013-304197

Background Very preterm newborn infants often need cardiovascular support. More knowledge about myocardial function and factors that influence the immature myocardium may be helpful for optimising cardiovascular support in these infants. Objective Serial assessment of global myocardial function by means of colour tissue Doppler imaging (cTDI) in very and extremely preterm infants during the first 24 h of life. Study design One-centre, prospective, observational longitudinal cohort study in a third level Neonatal Intensive Care Unit. Sixty-five infants with median (range) gestational age (GA) 27 (24–31) weeks and birth weight (BW) 1049 (484–1620) g underwent echocardiographic examinations including cTDI at 5, 12 and 24 h after birth. Main outcome measures Peak systolic and peak diastolic annular velocity and peak annular displacement of the left and right ventricle. Results There was a significant reduction in systolic and diastolic velocities and displacement of both ventricles from 5 to 12 h age. From 12 to 24 h, there was a non-significant increase in myocardial velocities and displacement. At 5 h, babies with haemodynamically significant patent ductus arteriosus (PDA) had significantly higher systolic and diastolic velocities in both ventricles than those with non-significant PDA. Conclusions Myocardial tissue velocities decrease significantly from 5 to 12 h after birth in very preterm infants. Further studies are needed to confirm these results and to determine their clinical implications.