Effect of Phototherapy on Cardiac Functions in Neonates with Hyperbilirubinemia. A Prospective Cross-Sectional Study

Abstract

Background: Phototherapy has been reported to alter cardiovascular function by causing increased peripheral blood flow, diminished cardiac output and increased sympathetic activity that may be of concern, particularly in neonates with hyperbilirubinemia. Aim of work: To assess the myocardial function in neonates with hyperbilirubinemia by using echocardiography, especially tissue Doppler imaging (TDI). Patients and Methods: It was a prospective, cross-sectional study. All participants in this study were full-terms and appropriate for gestational age newborns with hyperbilirubinemia who received phototherapy for jaundice (bilirubin level greater than 15 mg/dl). Myocardial functions were assessed using conventional echocardiography and tissue Doppler imaging techniques. Results: The study population consisted of 110 neonates with hyperbilirubinemia; their mean gestational age was 38.8 ± 1.7 weeks and mean birth weight 2785 ± 652 g. After phototherapy, respiratory rate and heart rate were faster whereas oxygen saturation and systolic blood pressure were lower (p <0.000). There was no significant difference in the left ventricular interventricular septum in diastole (LVIVSd), left ventricular interventricular septum in systole (LVIVSs), left ventricular internal dimension in diastole (LVIDd), left ventricular internal dimension in systole (LVIDs), left ventricular posterior wall in diastole (LVPWd), left ventricular posterior wall in systole (LVPWs), ejection fraction (EF) and fraction shortening (FS) before and after phototherapy (p >0.05). Pulsed wave Doppler parameters showed no significant difference in the mitral E velocity, mitral A velocity, and E/A ratio (p > 0.05). Conclusion:Phototherapy had no adverse effects on either systolic or diastolic function of the left ventricle in term neonates with indirect hyperbilirubinemia.