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Background: Myocardial function in very-low-birth-weight infants (VLBWIs) develops during early postnatal life, but different patterns of temporal evolution that might be related to the development of bronchopulmonary dysplasia (BPD) are not completely understood. Methods: A prospective cohort study including VLBWIs admitted to our NICU from January 2015 to 2017 was conducted. Plasma N-terminal pro B type natriuretic peptide (NTproBNP) levels were measured, and echocardiograms were performed at 24 and 72 h of life and weekly thereafter until 36 weeks of postmenstrual age (PMA). We measured the tricuspid annular plane systolic excursion (TAPSE) by M-mode; the lateral tricuspid E', A', and S' waves; and the myocardial performance index (MPI) by tissue doppler imaging (TDI). The subjects were divided into non-BPD and BPD groups. Results: We included 101 VLBWIs. The TAPSE and E', A', and S' waves increased while MPI-TDI decreased over time. Birth gestational age (GA) and postnatal PMA impacted these parameters, which evolved differently in those who developed BPD compared to those in the non-BPD group. The NTproBNP levels at 14 days of life and different echocardiographic parameters were associated with the development of BPD in different multivariate models. Conclusion: TAPSE and TDI values depend on GA and PMA and follow a different temporal evolution that is related to the later development of BPD. Combined biochemical and echocardiographic biomarkers can help identify which VLBWIs are at higher risk of developing BDP.

The results of our study suggest that SGA infants with a good prognosis have a more mature aEEG pattern than preterm adequate-for-gestational-age patients with the same outcome. These findings support the brain sparing theory in SGA infants.

Abstracts Objectives This study aims to analyze the variability between two trained neonatologists when performing consecutive echocardiograms using tissue Doppler imaging (TDI) and conventional methods in very low birth weight infant (VLBWI). Methods Two serial echocardiograms were performed in 30 VLBWI infants. The echocardiographic parameters analyzed were tricuspid annular plane systolic excursion (TAPSE), A′, E′, and S′ waves, and myocardial performance index acquired by TDI (MPI‐TDI) of both ventricles and shortening fraction (SF). The intra‐observer and inter‐observer agreements and the intra‐operator agreement were analyzed using quantitative and qualitative statistical methods. Results The intra‐observer agreement was very good, TAPSE, and TDI‐derived parameters had an intra‐class correlation (ICC) > 0.8. TDI‐derived velocities had a coefficient of variation (COV) < 11%, while MPI‐TDI had a COV between 20%–28%. The inter‐observer agreement was excellent. There was greater variability when analyzing intra‐operator agreement, with the least variable parameter being TAPSE. According to PABAK, the variability presented moderately substantial agreement. Conclusions Tricuspid annular plane systolic excursion is very reproducible between observers and operators. Measurements of TDI wave velocities are more reproducible than MPI‐TDI. TDI is sufficiently reproducible in the VLBWI if adequate training is performed, and guidelines are followed to obtain standardized echocardiographic images.