Echocardiographic parameters of patent ductus arteriosus in preterm infants

Khositseth, Anant; Nuntnarumit, Pracha; Chongkongkiat, P.

doi:10.1007/s13312-011-0127-5

Cited by 18 publications

(18 citation statements)

References 14 publications

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“…The device closure group in this study showed significantly higher LAV and LAVI compared to the coil closure group. This was in agreement with the results of Khositseth et al . who found that LAVI may be a better indicator of the volume load of the heart in haemodynamically significant PDA in preterm infants.…”

Section: Discussionsupporting

confidence: 93%

“…The device closure group in this study showed significantly higher LAV and LAVI compared to the coil closure group. This was in agreement with the results of Khositseth et al 29 who found that LAVI may be a better indicator of the volume load of the heart in haemodynamically significant PDA in preterm infants. Our results were also in agreement with that of Jantzen et al 30 who stated that ROC curve showed indexed LA volumes to have moderate power to discriminate hemodynamically significant PDA from low hemodynamic burden PDA.…”

Section: T a B L E 3 Comparison Between Receiver Operating Characterisupporting

confidence: 93%

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Echocardiographic predictors of coil vs device closure in patients undergoing percutaneous patent ductus arteriosus closure

2017

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Aim:To determine anatomic and hemodynamic echocardiographic predictors for patent ductus arteriosus (PDA) device vs coil closure. Methods:Seventy-six patients who were referred for elective transcatheter PDA closure were enrolled in the study. All patients underwent full echocardiogram including measurement of the PDA pulmonary end diameter, color flow width and extent, peak and end-diastolic Doppler gradients across the duct, diastolic flow reversal, left atrial dimensions and volume, left ventricular sphericity index, and volumes. Results:The study group was subdivided into 2 subgroups based on the mode of PDA closure whether by coil (n = 42) or device (n = 34). Using univariate analysis there was a highly significant difference between the 2 groups as regard the pulmonary end diameter measured in both the suprasternal and parasternal short-axis views as well as the color flow width and color flow extent (P < .0001). The device closure group had statistically significant higher end-systolic and end-diastolic volumes indexed, left atrial volume, and diastolic flow reversal. Receiver operating characteristic curve analysis showed a pulmonary end diameter cutoff point from the suprasternal view > 2.5 mm and from parasternal short-axis view > 2.61 mm to have the highest balanced sensitivity and specificity to predict the likelihood for device closure (AUC 0.971 and 0.979 respectively). The pulmonary end diameter measured from the suprasternal view was the most independent predictor of device closure.

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Section: Discussionsupporting

confidence: 93%

Section: T a B L E 3 Comparison Between Receiver Operating Characterisupporting

confidence: 93%

Echocardiographic predictors of coil vs device closure in patients undergoing percutaneous patent ductus arteriosus closure

2017

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“…In order to properly implement the pre-symptomatic strategy, we need markers that combine three qualities at a time: early, accurate, and easily repeatable by trained neonatologists. The presence of those three qualities at a time is challenging; the easily repeatable parameters such as left atrial to aortic ratio (LA/Ao) have a low accuracy [3] and the highly accurate parameters such as the absence of retrograde diastolic flow in the superior mesenteric artery and the left ventricular outflow to superior vena caval flow ratio (LVO/SVC) are not easily repeatable [4].…”

Section: Introductionmentioning

confidence: 99%

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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“…14 Khositseth et al measured LAV/BSA 1 in very LBWI using a prolate ellipse method. 15 However, no study of LAV has specifically targeted ELBWIs, in whom PDA is considerably more clinically important than in any other birth weight group. In addition, indexing chamber volumes using BSA to the exponent of 1 may be physiologically incorrect, 16 because an allometric model has been validated as the appropriate mathematical scaling for various cardiovascular structures to adjust for body size.…”

Section: Discussionmentioning

confidence: 99%

“…14 Khositseth et al used the prolate ellipse method, in which 3-dimensional diameters are multiplied, to calculate LAV, and assessed the relationship between LAV/BSA 1 and PDA in preterm infants with gestational age <33 weeks. 15 Although caution should be exercised because the prolate ellipse method routinely yields smaller values than either the area-length or Simpson method, 28 the mean LAV/BSA 1 was 9.1±4.2 ml/m 2 in hemodynamically significant PDA (mean gestational age 29.4 weeks, mean birth weight 1,237 g) and 6.1±2.0 ml/m 2 in non-hemodynamically significant PDA (mean gestational age 29.5 weeks, mean birth weight 1,296 g).…”

Section: Reference Value and Body Size Correction Of Lav In Elbwismentioning

confidence: 99%

Left Atrial Volume Is Superior to the Ratio of the Left Atrium to Aorta Diameter for Assessment of the Severity of Patent Ductus Arteriosus in Extremely Low Birth Weight Infants

Toyoshima

Masutani

Senzaki

et al. 2014

Circ J

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Background: This study was undertaken to establish the appropriate correction of left atrial volume (LAV) to body surface area (BSA) to provide reference values and to assess the hypotheses that LAV is useful for assessing patent ductus arteriosus (PDA) severity in extremely low birth weight infants (ELBWI) and could overcome the limitations of the LA-to-aortic dimension ratio (LA/Ao). Methods and Results:Echocardiograms with 318 data points from 53 consecutive ELBWIs were assessed. PDA surgery was performed within the first 2 weeks in 6 patients. LAV was measured using the biplane (LAV) and singleplane (LAV4CV) area-length methods. The allometric model was used to correlate LAV to BSA. LAV4CV had a good correlation with LAV (R=0.93). Although LAV/BSA 1 had a residual relationship with BSA, LAV/BSA 1.54 (23.5±9.3 ml/m 3.08 ) and LAV4CV/BSA 1.52 (21.4±9.4 ml/m 3.04 ) did not. Receiver-operating characteristic analysis to detect hemodynamic status just before PDA surgery showed the superiority of LAV/BSA 1.54 (area under the curve (AUC) 0.97) and LAV4CV/ BSA 1.52 (AUC 0.98) over LA/Ao (AUC 0.92). Moreover, LAV/BSA 1.54 and LAV4CV/BSA 1.52 were better correlated with left pulmonary arterial end-diastolic velocity than was LA/Ao. Conclusions:This study provided appropriate BSA correction of LAV and its reference values in ELBWIs. LAV indices may be superior to LA/Ao for PDA severity assessment. Measurement of single-plane LAV is easy, with similar usefulness to biplane LAV. (Circ J 2014; 78: 1701 -1709

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Echocardiographic parameters of patent ductus arteriosus in preterm infants

Abstract: In preterm infants with hsPDA, there was a volume load of the left heart causing increased stroke volume and cardiac output. The hsPDA could be detected by echocardiography even in the first 48 hours. The left atrial volume index may be a better indicator of the volume load of the heart.

Cited by 18 publications

References 14 publications

Echocardiographic predictors of coil vs device closure in patients undergoing percutaneous patent ductus arteriosus closure

Echocardiographic predictors of coil vs device closure in patients undergoing percutaneous patent ductus arteriosus closure

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

Left Atrial Volume Is Superior to the Ratio of the Left Atrium to Aorta Diameter for Assessment of the Severity of Patent Ductus Arteriosus in Extremely Low Birth Weight Infants

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