Maturational Patterns of Systolic Ventricular Deformation Mechanics by Two-Dimensional Speckle-Tracking Echocardiography in Preterm Infants over the First Year of Age

被引：63

作者：

Levy, Philip T. ^{[1
,2
]}

EL-Khuffash, Afif ^{[3
,4
]}

Patel, Meghna D. ^{[1
]}

Breatnach, Colm R. ^{[3
]}

James, Adam T. ^{[3
]}

Sanchez, Aura A. ^{[6
]}

Abuchabe, Cristina ^{[1
]}

Rogal, Sarah R. ^{[2
]}

Holland, Mark R. ^{[7
]}

McNamara, Patrick J. ^{[8
,9
]}

Jain, Amish ^{[11
]}

Franklin, Orla ^{[5
]}

Mertens, Luc ^{[10
]}

Hamvas, Aaron ^{[12
]}

Singh, Gautam K. ^{[1
]}

机构：

[1] Washington Univ, Sch Med, Dept Pediat, St Louis, MO 63110 USA

[2] Goryeb Childrens Hosp, Dept Pediat, Morristown, NJ USA

[3] Rotunda Hosp, Dept Neonatol, Dublin, Ireland

[4] Royal Coll Surgeons Ireland, Dept Paediat, Sch Med, Dublin, Ireland

[5] Our Ladys Childrens Hosp Crumlin, Dept Cardiol, Dublin, Ireland

[6] Univ Minnesota, Dept Pediat, Minneapolis, MN 55455 USA

[7] Indiana Univ Purdue Univ, Dept Radiol & Imaging Sci, Indianapolis, IN 46202 USA

[8] Hosp Sick Children, Div Neonatol, Toronto, ON, Canada

[9] Hosp Sick Children, Dept Physiol, Toronto, ON, Canada

[10] Hosp Children, Labatt Family Heart Ctr, Div Cardiol, Toronto, ON, Canada

[11] Mt Sinai Hosp, Dept Paediat, Toronto, ON, Canada

[12] Northwestern Univ, Dept Pediat, Feinberg Sch Med, Chicago, IL 60611 USA

来源：

JOURNAL OF THE AMERICAN SOCIETY OF ECHOCARDIOGRAPHY | 2017年 / 30卷 / 07期

基金：

美国国家卫生研究院;

关键词：

Cardiac function; Prematurity; Strain imaging; Echocardiography; PATENT DUCTUS-ARTERIOSUS; NEONATES REFERENCE VALUES; 29 WEEKS GESTATION; STRAIN-RATE; PULMONARY-HYPERTENSION; ROTATIONAL MECHANICS; LONGITUDINAL STRAIN; MYOCARDIAL-FUNCTION; FRACTIONAL AREA; TISSUE DOPPLER;

D O I：

10.1016/j.echo.2017.03.003

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background: The aim of this study was to determine the maturational changes in systolic ventricular strain mechanics by two-dimensional speckle-tracking echocardiography in extremely preterm neonates from birth to 1 year of age and discern the impact of common cardiopulmonary abnormalities on the deformation measures. Methods: In a prospective multicenter study of 239 extremely preterminfants (< 29 weeks gestation at birth), left ventricular (LV) global longitudinal strain (GLS) and global longitudinal systolic strain rate (GLSRs), interventricular septal wall (IVS) GLS and GLSRs, right ventricular (RV) free wall longitudinal strain and strain rate, and segmental longitudinal strain in the RV free wall, LV free wall, and IVS were serially measured on days 1, 2, and 5 to 7, at 32 and 36 weeks postmenstrual age, and at 1 year corrected age (CA). Premature infants who developed bronchopulmonary dysplasia or had echocardiographic findings of pulmonary hypertension were analyzed separately. Results: In uncomplicated preterm infants (n = 103 [48%]), LV GLS and GLSRs remained unchanged from days 5 to 7 to 1 year CA (P = .60 and P = .59). RV free wall longitudinal strain, RV free wall longitudinal strain rate, and IVS GLS and GLSRs significantly increased over the same time period (P < .01 for all measures). A significant base-to-apex (highest to lowest) segmental longitudinal strain gradient (P < .01) was seen in the RV free wall and a reverse apex-to-base gradient (P < .01) in the LV free wall. In infants with bronchopulmonary dysplasia and/or pulmonary hypertension (n = 119 [51%]), RV free wall longitudinal strain and IVS GLS were significantly lower (P < .01), LV GLS and GLSRs were similar (P = .56), and IVS segmental longitudinal strain persisted as an RV-dominant base-to-apex gradient from 32 weeks postmenstrual age to 1 year CA. Conclusions: This study tracks the maturational patterns of global and regional deformation by two-dimensional speckle-tracking echocardiography in extremely preterm infants from birth to 1 year CA. The maturational patterns are ventricular specific. Bronchopulmonary dysplasia and pulmonary hypertension leave a negative impact on RV and IVS strain, while LV strain remains stable.

引用

页码：685 / U249

页数：15

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