Left Ventricular Function in Healthy Term Neonates During the Transitional Period

Jain, Amish; El-Khuffash, Afif; Kuipers, Bart C.W.; Mohamed, Adel; Connelly, Kim A.; McNamara, Patrick J.; Jankov, Robert P.; Mertens, Luc

doi:10.1016/j.jpeds.2016.11.003

Cited by 58 publications

(65 citation statements)

References 26 publications

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“…Echocardiograms were performed using the Phillips iE33 ultrasound machine equipped with a standard transducer (Phillips Healthcare, Andover, MA, USA). The echocardiogram images obtained adhered to the American Society of Echocardiography (ASE) protocols for transthoracic pediatric echocardiograms [12-14]. This included 2D imaging, color Doppler, and spectral Doppler in the subcostal, parasternal short axis, parasternal long axis, apical four chamber (4C), and suprasternal notch views.…”

Section: Methodsmentioning

confidence: 99%

“…This included 2D imaging, color Doppler, and spectral Doppler in the subcostal, parasternal short axis, parasternal long axis, apical four chamber (4C), and suprasternal notch views. Additionally, we employed protocols approved by ASE for newborns during the transition period [12, 13]. All echocardiograms were performed by 1 of 4 registered diagnostic cardiac sonographers with pediatric echocardiography certification.…”

Section: Methodsmentioning

confidence: 99%

“…LV mass was calculated by two methods: M-mode [16] and 2D echo using the area/length method [17]. Ventricular function was evaluated in accordance with ASE recommendations [12-14]. The fractional area of change was used as a marker of RV systolic function [18].…”

Section: Methodsmentioning

confidence: 99%

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A Prospective Study Evaluating the Effects of SSRI Exposure on Cardiac Size and Function in Newborns

et al. 2019

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Background: Selective serotonin reuptake inhibitors (SSRIs) are antidepressants prescribed in 10% of pregnancies in the USA. We have previously shown in preclinical studies that sertraline exposure impacts cardiomyocyte development, leading to reductions in left ventricular size and cardiac function. Objectives: We hypothesized that in utero SSRI exposure will lead to reduced left ventricular dimensions and cardiac function on echocardiography immediately after birth. Methods: Twenty term infants with and 21 term infants without in utero exposure to SSRIs underwent echocardiograms to assess cardiac size and function. The exclusion criteria for infants were prematurity, small or large for gestational age, any respiratory or cardiovascular support needed after birth, and any major congenital malformation. Results: Infants exposed to in utero SSRIs had significantly reduced right ventricular dimensions in the diastole (controls 1.0 cm [0.86, 1.20], SSRI 0.89 cm [0.730, 1.05], p = 0.03), and left ventricular lengths in the diastole and systole (diastole: controls 3.4 cm [3.25, 3.65], SSRI 3.25 cm [3.10, 3.45], p = 0.03; systole: controls 2.9 cm [2.65, 3.05], SSRI 2.6 cm [2.50, 2.85], p = 0.01). No differences were observed in cardiac function. Importantly, there were no differences in maternal conditions or infant birth weight, body surface area, or gestational age. Conclusions: Our findings suggest an association between in utero exposure to SSRIs and ventricular size in infants. Given the increasing use of SSRIs during pregnancy and the importance of early life programming on future cardiovascular health, larger studies need to be completed to determine if in utero SSRI exposure impacts ventricular size.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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A Prospective Study Evaluating the Effects of SSRI Exposure on Cardiac Size and Function in Newborns

et al. 2019

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“…The echocardiography images and cine loops were stored as raw data and analysed later using dedicated vendor-customised commercially available software (EchoPAC v112; General Electric Medical Systems, Waukesha, WI, USA). A comprehensive echocardiographic assessment to measure bi-ventricular function was performed; detailed methodology is described elsewhere [11,12,15]. …”

Section: Methodsmentioning

confidence: 99%

“…With the emergence of new echocardiography modalities including the deformation and rotational characteristics of the left ventricle, and right ventricle-specific measurements, a detailed characterisation of myocardial performance in various disease states and physiological milieus is now possible [9,10]. Those measurements are feasible in the neonatal population and demonstrate excellent intra- and inter-rater reproducibility [11,12]. …”

Section: Introductionmentioning

confidence: 99%

The Impact of Maternal Gestational Hypertension and the Use of Anti-Hypertensives on Neonatal Myocardial Performance

Breatnach¹,

Monteith²,

McSweeney³

et al. 2017

Neonatology

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Background: Assessment of myocardial performance in neonates using advanced techniques such as deformation imaging and rotational mechanics has gained considerable interest. The applicability of these techniques for elucidating abnormal myocardial performance in various clinical scenarios is becoming established. We hypothesise that term infants born to mothers with gestational hypertension (GH) may experience impaired performance of the left and right ventricles during the early neonatal period. Objectives: We aimed to assess left and right ventricular (LV and RV) function using echocardiography in infants born to mothers with GH and compare them to a control group. Methods: Term infants (>36⁺⁶ weeks) born to mothers with GH underwent assessment to measure biventricular function using ejection fraction (EF), deformation imaging, left-ventricle rotational mechanics (apical rotation, basal rotation, twist, twist rate, and untwist rate), and right ventricle-specific functional parameters (tricuspid annular plane systolic excursion and fractional area change) in the first 48 h after birth. A control group comprising infants born to healthy mothers was used for comparison. Results: Fifteen infants with maternal GH and 30 age-matched controls were enrolled. The GH infants exhibited no differences in birthweight or LV or RV length, but they had lower EF (54 vs. 61%; p < 0.01), LV global longitudinal strain (-20 vs. -25%; p < 0.01), and LV twist (11 vs. 16°; p = 0.04). There were no differences in any of the RV functional parameters. Conclusion: Infants born to mothers with GH exhibited lower LV function than healthy controls, while RV function appeared to be preserved. This relationship warrants further exploration in a larger cohort.

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Tissue‐Tracking Mitral Annular Displacement in Neonates

Ficial,

Benfari,

Bonafiglia

et al. 2023

J of Ultrasound Medicine

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ObjectivesTo assess the feasibility, accuracy, and reproducibility of tissue‐tracking mitral annular displacement (TMAD) compared with other measures of left ventricular systolic function in healthy preterm and term neonates in the transitional period.MethodsThis was a prospective observational study. Two echocardiograms were performed at 24 and 48 hours of life. TMAD, shortening fraction (SF), ejection fraction (EF), s′, and global longitudinal strain (GLS) were measured offline. Accuracy to detect impaired GLS was tested by ROC curve analysis. DeLong test was used to compare AUCs. Intra and interobserver reproducibility of the off‐line analysis was calculated.ResultsMean ± SD gestational age and weight were 34.2 ± 3.8 weeks and 2162 ± 833 g, respectively. TMAD was feasible in 168/180 scans (93%). At 24 hours the AUC (95% CI) of SF, EF, s′, and TMAD (%) was 0.51 (0.36–0.67), 0.68 (0.54–0.82), 0.63 (0.49–0.77), and 0.89 (0.79–0.99) respectively. At 48 hours the AUC (95% CI) of SF, EF, s′, and TMAD (%) was 0.64 (0.51–0.77), 0.59 (0.37–0.80), 0.70 (0.54–0.86), and 0.96 (0.91–1.00), respectively. The AUC of TMAD was superior to the AUC of SF, EF, s′, at both timepoints (P < .02). Intraclass correlation coefficients (95% CI) of intra and interobserver reproducibility of TMAD were 0.97 (0.95–0.99) and 0.94 (0.88–0.97), respectively.ConclusionTMAD showed improved accuracy and optimal reproducibility in neonates in the first 48 hours of life.

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Left Ventricular Function in Healthy Term Neonates During the Transitional Period

Cited by 58 publications

References 26 publications

A Prospective Study Evaluating the Effects of SSRI Exposure on Cardiac Size and Function in Newborns

A Prospective Study Evaluating the Effects of SSRI Exposure on Cardiac Size and Function in Newborns

The Impact of Maternal Gestational Hypertension and the Use of Anti-Hypertensives on Neonatal Myocardial Performance

Tissue‐Tracking Mitral Annular Displacement in Neonates

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