Assessment of myocardial function in preterm infants with chronic lung disease using tissue doppler imaging

Research output: Contribution to journalArticlepeer-review

Authors

  • Phani Yajamanyam
  • Andrew Ewer
  • Robert Negrine
  • SV Rasiah
  • Javier Zamora

Abstract

Objectives: To assess myocardial function and presence of pulmonary hypertension (PH) using both tissue Doppler imaging (TDI) and conventional echocardiography in preterm infants <32weeks gestation with chronic lung disease (CLD).Design: Prospective observational study.Setting: Tertiary neonatal intensive care unit. Patients: Three groups of preterm infants were recruited. Group 1 - CLD receiving positive pressure airway support [including high-flow humidified nasal cannula oxygen] (n=25). Group 2 - CLD receiving low-flow nasal oxygen (n=25) and group 3 no CLD (n=22).Methods: Echocardiography was performed around 36 weeks corrected gestational age. Myocardial function and PH were assessed using both conventional (left ventricular fractional shortening [LVFS] and left ventricular output [LVO], tricuspid regurgitation and ventricular septal flattening) and TDI techniques (myocardial velocities, myocardial performance index [MPI] and right ventricular isovolumetric relaxation time [RV-IVRT]).Results: The MPI of right (RV) and left (LV) ventricles was significantly higher in CLD infants: mean RV MPI group 1 – 0.79, group 2 – 0.65 and group3 – 0.52. LV MPI: group 1 – 0.77, group 2 – 0.70 and group 3 – 0.45. There was a trend towards higher MPIs in group 1 compared to group 2. LVFS and LVO were similar across all three groups. RV-IVRT was also significantly higher in infants with CLD infants (group 1 – 0.06 seconds, group 2 – 0.06 seconds and group 3 – 0.05 seconds). PH was not detected by conventional echocardiography. Conclusion: Infants with CLD have evidence of relative biventricular dysfunction and higher pulmonary arterial blood pressure as demonstrated by TDI which were not detected by conventional echocardiography.

Details

Original languageEnglish
JournalArchives of disease in childhood. Fetal and neonatal edition
Early online date5 Apr 2016
Publication statusE-pub ahead of print - 5 Apr 2016

Keywords

  • Preterm infants, echocardiography, tissue Doppler, chronic lung disease, pulmonary hypertension