Assessment of Left Ventricular Adaptation to Extrauterine Circulation

Lundell, Bo; Wallgren, C. Göran

doi:10.1111/j.1651-2227.1982.tb09513.x

Cited by 10 publications

(9 citation statements)

References 33 publications

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“…At present there is no available non-invasive technique for accurate quantitation of the ductus flow, but studies of left ventricular systolic time intervals also seem to show early disappearance of a haemodynamically important ductus shunt. 27 The sleep/wake state may also influence left ventricular output. At the first two recordings the infants were awake and left ventricular output was high, whereas at the two last recordings most infants were asleep and left ventricular output was lower.…”

Section: Discussionmentioning

confidence: 99%

Left ventricular output during postnatal circulatory adaptation in healthy infants born at full term.

Winberg

Jansson

Marions

et al. 1989

Archives of Disease in Childhood

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Left ventricular output was measured non-invasively at predefined time intervals from less than 15 minutes to 72 hours after birth in 16 infants who had been born at full term. The blood flow velocity in the ascending aorta was measured by a range gated Doppler technique and multiplied by the cross sectional diameter measured by cross sectional and M mode echocardiography. Left ventricular output remained high in the first two hours, 235-243 ml/min/kg, despite a 10% decrease in heart rate. The fall in heart rate was compensated for by a 15% increase in stroke volume. Between 2 and 24 hours there was a significant fall in mean (SD) left ventricular output to 187 (35) ml/min/kg caused mainly by a reduction in stroke volume. The fall in left ventricle output after two hours may reflect an adaptation to the decreased demand on the left ventricle as the ductus constricts.

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Section: Discussionmentioning

confidence: 99%

Left ventricular output during postnatal circulatory adaptation in healthy infants born at full term.

Winberg

Jansson

Marions

et al. 1989

Archives of Disease in Childhood

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“…In a previous study of changes in left ventricular systolic time intervals (STI) in term infants during the first three days after birth (9), we suggested that the short preejection intervals seen immediately after birth reflected increased left ventricular volume load. Normalization of these intervals 4-6 hours after birth was thought to coincide with ductal closure and reduced volume load to the left vent ricle .…”

mentioning

confidence: 98%

Left Ventricular Systolic Time Intervals in Preterm Infants With Patent Ductus Arteriosus

Lundell

Wallgren

1983

Acta Paediatrica

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Left ventricular systolic time intervals were recorded by a non-invasive technique, from the axillary artery, in 13 preterm infants with patent ductus arteriosus. At the onset of clinical symptoms, consistent with a large left-to right ductal shunt, the preejection intervals were shorter than in a control group of nine preterm infants without a patent ductus. The most pronounced difference was found in the shortening of the isovolumic contraction time, 10.7 msec in the ductus group compared with 22.4 msec in the control group. Ductal closure normalized the isovolumic contraction time to 22.1 msec. The very short preejection intervals, associated with a large ductal shunt, are suggested to reflect a combination of reduced aortic diastolic pressure and increased left ventricular filling pressure. In spite of increased volume load to the left ventricle there were no detectable changes in the systolic time intervals indicating impaired left ventricular function. The left ventricle seems to be competent to handle increased volume load in the presence of reduced afterload in preterm infants with symptomatic left-to right ductal shunts.

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“…Again, in the majority of these investigations an increase of the end-diastolic left ventricular volume [31,33,69] and of myocardial performance [45,46,48,68] was observed in the human newborn after birth while one study yielded contradictory results [18].…”

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confidence: 99%

Changes of the cardiovascular system during the perinatal period

Stopfkuchen¹

1987

Eur J Pediatr

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After describing the particular features of the fetal circulation, changes in the pattern of blood flow at the time of birth and during early neonatal life are explained. From animal studies it is wellknown that during the first hours and weeks after birth newborns are characterized by an extremely high cardiac output due to high metabolic demands. In order to meet this marked volume loading, already under resting conditions the neonatal heart appears to be operating nearly at its full capacity without reserves in contractility, preload and afterload. Consequently the newborn heart has less ability to cope with additional acute afterload and/or preload stress. Few investigations on cardiac output and myocardial performance in healthy human newborns provide presumptive evidence that the postnatal human heart performs probably as well as the heart of other species. These observations may influence the therapeutic approach in clinical situations with additional alterations in loading conditions.

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Assessment of Left Ventricular Adaptation to Extrauterine Circulation

Cited by 10 publications

References 33 publications

Left ventricular output during postnatal circulatory adaptation in healthy infants born at full term.

Left ventricular output during postnatal circulatory adaptation in healthy infants born at full term.

Left Ventricular Systolic Time Intervals in Preterm Infants With Patent Ductus Arteriosus

Changes of the cardiovascular system during the perinatal period

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