Preterm Birth Is Associated with Altered Myocardial Function in Infancy

• Published in: Journal of the American Society of Echocardiography Vol. 29; no. 7; pp. 670 - 678
• Main Authors: Schubert, Ulf, MD, Müller, Matthias, MD, PhD, Abdul-Khaliq, Hashim, MD, PhD, Norman, Mikael, MD, PhD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.07.2016
• Subjects: Age Distribution; Cardiac function; Cardiovascular; Causality; Comorbidity; Echocardiography - statistics & numerical data; Female; Germany - epidemiology; Humans; Incidence; Infant; Infant, Newborn; Longitudinal Studies; Male; Medicin och hälsovetenskap; Premature Birth - diagnostic imaging; Premature Birth - epidemiology; Preterm infant; Reproducibility of Results; Risk Factors; Sensitivity and Specificity; Speckle-tracking echocardiography; Ventricular Dysfunction - diagnostic imaging; Ventricular Dysfunction - epidemiology; LVM; SV; Patent ductus arteriosus; RV; IVS; Left ventricular; MPI; LV; Left ventricular mass; Myocardial performance index; PDA; ROI; Stroke volume; Speckle-tracking echocardiography; Preterm infant; Region of interest; Cardiac function; Right ventricular; Interventricular septum
• ISSN: 0894-7317; 1097-6795; 1097-6795
• DOI: 10.1016/j.echo.2016.03.011

Background Preterm birth has been associated with myocardial remodeling and accelerated cardiovascular ageing in later life, but the underlying mechanisms are unknown. The investigators used echocardiography to undertake a sequential analysis of myocardial function in preterm infants. Methods This study evaluated the cardiac performance of 25 very preterm infants (born at a gestational age of 26–30 weeks), at birth, 3 months (term-equivalent age), and 6 months later (3 months of corrected age). Speckle-tracking echocardiography was used to determine myocardial function, assessing the magnitude of myocardial deformation as longitudinal strain, deformation rate (strain rate), and velocity in both ventricles during systole and diastole. The results were compared with those in 30 infants born at term investigated at birth and at 3 months of age. Results At term-equivalent age, the speckle-tracking estimates were similar in both groups. Three months later, very preterm infants exhibited significantly lower left ventricular mean free wall longitudinal strain (−20.0% vs −22.0%, P  = .010) and lower left ventricular early diastolic (median, −7.37 vs −10.9 cm/sec, P  = .003) and late diastolic (median, −5.11 vs −6.95 cm/sec, P  = .009) myocardial velocities than infants born at term. There were no statistically significant group differences in right ventricular or interventricular septal measurements. Conventional echocardiographic variables did not differ significantly between the two groups at any age. Conclusions Very preterm infants develop altered left ventricular myocardial function 6 months after birth. Follow-up examinations are needed to determine the implications for cardiovascular health in the growing number of children surviving very preterm birth.