Right ventricular performance using myocardial deformation imaging in infants with bronchopulmonary dysplasia

• Published in: Journal of perinatology Vol. 37; no. 1; pp. 81 - 87
• Main Authors: Haque, U, Stiver, C, Rivera, B K, Richards, B, Ma, N, Cua, C L, Smith, C V, Backes, C H
• Format: Journal Article
• Language: English
• Published: New York Nature Publishing Group US 01.01.2017; Nature Publishing Group
• Subjects: 692/308/409; 692/699/75/243; 692/700/1421; Analysis; Blood pressure; Bronchopulmonary dysplasia; Bronchopulmonary Dysplasia - diagnostic imaging; Bronchopulmonary Dysplasia - physiopathology; Childrens health; Complications and side effects; Deformation; Demographic aspects; Diagnosis; Echocardiography; Echocardiography, Doppler; Female; Gestational age; Health aspects; Heart assist devices; Heart ventricle, Right; Heart Ventricles - diagnostic imaging; Heart Ventricles - physiopathology; Hospitals; Humans; Hypertension, Pulmonary - diagnostic imaging; Hypotheses; Infant; Infant, Newborn; Infants; Infants (Premature); Lung diseases; Male; Medical examination; Medicine; Medicine & Public Health; Methods; Myocardial Contraction; original-article; Pediatric Surgery; Pediatrics; Prospective Studies; Pulmonary hypertension; Severity of Illness Index; United States; Ventricular Function, Right - physiology; United States; United States > US; Ohio
• ISSN: 0743-8346; 1476-5543
• DOI: 10.1038/jp.2016.173

Objective: Right ventricular (RV) performance among infants with bronchopulmonary dysplasia (BPD) remains poorly understood. We tested the hypothesis that myocardial deformation imaging (MDI) strain and strain rate would allow for differentiation between infants with severe and milder forms of BPD, independent of tissue Doppler imaging (TDI) and superior to conventional echocardiographic measurements. Study Design: Infants with various severities of BPD (11 with none or mild, 13 with moderate and 10 with severe) underwent conventional echocardiography, TDI and MDI assessments at >36 weeks of corrected gestational age. BPD severity grading was determined according to the National Institutes of Child Health and Disease workshop rating scale by physicians blinded to the echocardiogram results. Group data were compared with one-way analysis of variance or Kruskal–Wallis tests, with post hoc multiple comparisons. Results: No differences in traditional echocardiographic parameters or TDI among the three BPD severity groups were observed; none of the infants had evidence of pulmonary hypertension. Using MDI, infants with severe BPD had lower peak global systolic strain than did infants with moderate BPD ( P <0.01) or mild/none BPD ( P <0.01). Early and late diastolic strain rate measurements were similar across the three groups. Conclusions: Among infants with severe forms of BPD, evidence of abnormal RV systolic function was detected with MDI, but not traditional echocardiographic or TDI measurements. Infants with severe forms of BPD may represent a particularly high-risk subgroup for decreased RV performance warranting cardiac surveillance. MDI should be considered as a method to quantitate RV function in this population.