Assessment of myocardial function in preterm infants with chronic lung disease using tissue doppler imaging
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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.
|Journal||Archives of disease in childhood. Fetal and neonatal edition|
|Early online date||5 Apr 2016|
|Publication status||E-pub ahead of print - 5 Apr 2016|
- Preterm infants, echocardiography, tissue Doppler, chronic lung disease, pulmonary hypertension