Early predictive echocardiographic features of hemodynamically significant patent ductus arteriosus in preterm VLBW infants

Polat, Tuğçin Bora; Çelik, İstemi Han; Erdeve, Ömer

doi:10.1111/ped.12915

Cited by 16 publications

(7 citation statements)

References 20 publications

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“…Results have showed that LA/Ao is delayed in proving hemodynamic significance of PDA. This is in agreement with previous studies that though it is easy to perform, its accuracy in predicting hemodynamic significance of PDA is low [14].…”

Section: Discussionsupporting

confidence: 92%

Development of tissue Doppler-derived predictors of hemodynamically significant patent ductus arteriosus and the ability to incorporate it in targeted neonatal echocardiography protocol

El-Saiedi

AbdelMassih

Sedky

et al. 2019

Journal of the Saudi Heart Association

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BackgroundHemodynamically significant (HS) patent ductus arteriosus (PDA) is a significant cause of mortality in preterm neonates. Early detection of HS PDA and pre-symptomatic closure may help in avoiding complications. For this to happen, easily performed predictors must be available; the aim of this paper is to test the reliability and repeatability of tissue Doppler-derived parameters for prediction of HS PDA.MethodsPreterm neonates <32 weeks were screened with echocardiography at Day 3 of life; 80 neonates with PDA were classified into HS group and hemodynamically insignificant (HIS) group based on benchmark parameter namely left ventricular outflow to superior vena caval flow ratio (LVO/SVC), and a ratio ≥4 was considered predictive of HS PDA. Tissue Doppler-derived left ventricular myocardial systolic and diastolic velocities were also performed.ResultsIn total, 105 neonates (55 among HS and 60 among HIS groups) were included in the study. Septal systolic velocity (S′) proved of high sensitivity (100%) in the prediction of HS PDA; nevertheless, it proved to be more repeatable than the initially discriminating parameter (LVO/SVC) with a Kappa of 0.92.ConclusionThis study concludes that septal S′ can be reliably used even by neonatologists for pre-symptomatic detection of HS PDA. This may also indicate the need of adding tissue Doppler parameters to the standard protocol of targeted neonatal echocardiography.

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Section: Discussionsupporting

confidence: 92%

Development of tissue Doppler-derived predictors of hemodynamically significant patent ductus arteriosus and the ability to incorporate it in targeted neonatal echocardiography protocol

El-Saiedi

AbdelMassih

Sedky

et al. 2019

Journal of the Saudi Heart Association

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“…Our data suggest that small gestational age may be an important risk factor for PDA outcome, which is consistent with the conclusions of previously studies [9,14]. Although no differences in birth weight were observed between groups, the correlation analysis showed that a lower birth weight was associated with smaller IT2 and Va values.…”

Section: Discussionsupporting

confidence: 92%

Echocardiographic assessment of intimal thickness growth of patent ductus arteriosus in neonates and analysis of influencing factors

Wang

Hou

et al. 2022

Int J Cardiovasc Imaging

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The spontaneous closure rate of patent ductus arteriosus (PDA) is high, and the necessity of early intervention is debated. Quantitative echocardiographic assessment of the intima in PDA has not been reported. This study evaluated intimal thickness growth in neonatal cases of PDA via echocardiography and investigated its correlation with clinical factors. Seventy-three neonates were enrolled, and echocardiography was performed three times: within 24 h post-birth (first echo), 48 h after the first echo (second echo), and before discharge (third echo). According to PDA outcome, the neonates were divided into the PDA-open group (n = 18 cases), PDA-closure at second echo group (n = 32 cases), and non-PDA at first echo group (n = 23 cases). We measured the intimal thickness (IT1 and IT2 at first and second echo, respectively), lumen diameter of ductus arteriosus (D1 and D2 at first and second echo, respectively), IT1/D1 ratio, and intimal thickness growth rate (V). Correlations between echocardiographic indicators, perinatal factors, and clinical treatment were analyzed. On first echo, the PDA-open group showed a significantly lower IT1/D1 than the combined PDA-closure group (P < 0.05). On second echo, the PDA-open group showed a significantly lower IT2 and V than the PDA-closure group as well as a significantly higher D2 (P < 0.05). Smaller gestational age correlated with a larger D2 but smaller IT2 and V (P < 0.05) and a higher level of respiratory support within 72 h post-birth correlated with a larger D2 and smaller IT 2 (P < 0.05). Increasing oxygen demand within 72 h of birth correlated with a larger D1 and D2 (P < 0.05). Echocardiographic assessment of intimal thickness growth in PDA may provide an approach for predicting spontaneous PDA closure, thereby guiding decision-making regarding early intervention.

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“…Eleven different articles were included in group 1 which contained preterm infants with a gestational age under 28 weeks and/or birth weight under 1,000 g ( 15 – 20 , 54 , 63 – 66 ). The median of reported mean or median GAs of the 17,156 patients in group 1 was 26.0 (range of mean/median 25.5–26.6) weeks.…”

Section: Resultsmentioning

confidence: 99%

Spontaneous Closure of the Ductus Arteriosus in Preterm Infants: A Systematic Review

et al. 2020

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The optimal management strategy for patent ductus arteriosus in preterm infants remains a topic of debate. Available evidence for a treatment strategy might be biased by the delayed spontaneous closure of the ductus arteriosus in preterm infants, which appears to depend on patient characteristics. We performed a systematic review of all literature on PDA studies to collect patient characteristics and reported numbers of patients with a ductus arteriosus and spontaneous closure. Spontaneous closure rates showed a high variability but were lowest in studies that only included preterm infants with gestational ages below 28 weeks or birth weights below 1,000 g (34% on day 4; 41% on day 7) compared to studies that also included infants with higher gestational ages or higher birth weights (up to 55% on day 3 and 78% on day 7). The probability of spontaneous closure of the ductus arteriosus keeps increasing until at least 1 week after birth which favors delayed treatment of only those infants that do not show spontaneous closure. Better prediction of the spontaneous closure of the ductus arteriosus in the individual newborn is a key factor to find the optimal management strategy for PDA in preterm infants.

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Early predictive echocardiographic features of hemodynamically significant patent ductus arteriosus in preterm VLBW infants

Abstract: Echocardiographic features such as short ductal length and short or absent ductal constriction area can be used to predict hsPDA for early decision making strategies in VLBW preterm infants.

Cited by 16 publications

References 20 publications

Development of tissue Doppler-derived predictors of hemodynamically significant patent ductus arteriosus and the ability to incorporate it in targeted neonatal echocardiography protocol

Development of tissue Doppler-derived predictors of hemodynamically significant patent ductus arteriosus and the ability to incorporate it in targeted neonatal echocardiography protocol

Echocardiographic assessment of intimal thickness growth of patent ductus arteriosus in neonates and analysis of influencing factors

Spontaneous Closure of the Ductus Arteriosus in Preterm Infants: A Systematic Review

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