Left ventricular dysfunction persists in the first week after rewarming following therapeutic hypothermia for hypoxic ischaemic encephalopathy

Phani Kiran Yajamanyam, RJS Negrine, Shree Vishna Rasiah, Marıa Nieves Plana, Javier Zamora, Andrew Ewer

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives: To assess serial myocardial function in newborn infants receiving therapeutic hypothermia (TH) as treatment for moderate to severe hypoxic-ischaemic encephalopathy (HIE).
Methods: Serial echocardiography was performed in 20 term infants receiving therapeutic hypothermia on days 1 to 3 and again after re-warming. Left ventricle (LV) fractional shortening, LV cardiac output and tissue Doppler imaging derived myocardial velocities and myocardial performance index were measured. Similar assessments were obtained from 20 well term infants within 48 hours of birth.
Results: LV fractional shortening (LVFS) was similar between cases and controls during all measurements (25.3% vs. 27.4%). Mean LV cardiac output on day 1 was significantly lower in cases (109ml/kg/min) than in controls (162ml/kg/min) but increased after re-warming (145ml/kg/min). All myocardial velocities were significantly lower in cases on day 1, increased during TH, but left ventricular indices remained consistently lower compared to controls even after re-warming. Left ventricular myocardial performance index was higher in cases compared to controls on day 1, improved during TH but remained abnormal after re-warming. Right ventricular myocardial performance index was similar between cases and controls.
Conclusion: Among infants affected by moderate to severe HIE, LV function appears to be more affected than right ventricular function with LV dysfunction persisting after completion of TH. LVFS was not useful to determine dysfunction in this cohort.
Original languageEnglish
JournalNeonatology
Publication statusAccepted/In press - 23 Dec 2021

Fingerprint

Dive into the research topics of 'Left ventricular dysfunction persists in the first week after rewarming following therapeutic hypothermia for hypoxic ischaemic encephalopathy'. Together they form a unique fingerprint.

Cite this