Longitudinal follow-up of ventricular performance in healthy neonates

Klitsie, Liselotte M.; Roest, Arno A.W.; Haak, Monique C.; Blom, Nico A.; Harkel, Arend D J Ten

doi:10.1016/j.earlhumdev.2013.08.019

Cited by 21 publications

(33 citation statements)

References 28 publications

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“…Other than circumferential systolic SR, there was no significant change in the deformation parameters between days 2 and 8. This finding is consistent with reports assessing LV circumferential and radial strain at the level of the papillary muscle between day 1 and 2 months of age in a healthy term cohort, demonstrating no difference in these parameters during that time period . Interestingly, the persevered measures during the transitional phase are also consistent with the observed patterns of LV longitudinal strain patterns during the transitional period, early neonatal period, and through 1 year of age in premature infants …”

Section: Discussionsupporting

confidence: 91%

“…In a 2D STE and cardiac MRI validation study, it was apparent that accurate tracking is affected by the frame rate‐to‐heart rate ratio (both too high and too low a frame rate), the nature of the strain (global being better than regional), and the shape of the ventricle (a normal ventricle tracking better than a single ventricle geometry) . In available published data, there is no apparent consistency regarding the chosen frame rate . Recent work by Sanchez et al.…”

Section: Discussionmentioning

confidence: 99%

“…There has been some interest in reporting 2D STE‐derived radial thickening and circumferential shortening of the LV in the human fetus, the premature neonate, the term neonate, and healthy children . However, there is a distinct lack of robust feasibility and reproducibility data on radial and circumferential strain in extremely premature infants < 29 weeks of gestation .…”

Section: Introductionmentioning

confidence: 99%

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Circumferential and radial deformation assessment in premature infants: Ready for primetime?

et al. 2019

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Background Speckle tracking echocardiography (STE) is a validated method to measure longitudinal deformation in premature infants, but there is a paucity of data on STE‐derived circumferential and radial strain in this population. We assessed the feasibility and reproducibility of circumferential and radial deformation measurements in premature infants. Methods In a prospective study of 40 premature infants (<29 weeks of gestation at birth), STE‐derived circumferential and radial strain, systolic strain rate (SRs), early diastolic strain rate (SRe), and late diastolic strain rate (SRa) were measured on day 2 and day 8. Intra‐ and inter‐observer reproducibility analysis were performed using Bland–Altman analysis, coefficient of variation (COV), and intra‐class correlation coefficient (ICC). The impact of a persistent patent ductus arteriosus (PDA) was analyzed. Results Deformation analysis was feasible in 98% of the acquisitions. Circumferential parameters demonstrated excellent intra‐ and inter‐observer reproducibility with an ICC between 0.89 and 0.99 (all P < 0.001) and a COV between 4% and 13%. Radial parameters demonstrated acceptable intra‐ and inter‐observer reproducibility with an ICC between 0.73 and 0.96 (all P < 0.001) and a COV between 14% and 27%. Infants with a PDA on day 8 (n = 21, 53%) demonstrated higher radial strain, SRs and SRe. There were no differences in circumferential parameters with a PDA at either time point. Conclusion This study demonstrates clinical feasibility and reproducibility of circumferential and radial strain by STE in premature infants. A PDA elevates radial deformation measures, suggesting that the increased LV preload from a PDA may augment intrinsic contractility in the radial but not circumferential plane.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Circumferential and radial deformation assessment in premature infants: Ready for primetime?

et al. 2019

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“…Two‐dimensional STE is a noninvasive technique that has been applied to assess myocardial mechanics in children and infants with cardiac and noncardiac disorders . Standardization of 2D image acquisition must be clearly established before routine clinical adoption of 2DSTE imaging in premature infants.…”

Section: Discussionmentioning

confidence: 99%

Effects of Frame Rate on Two‐Dimensional Speckle Tracking–Derived Measurements of Myocardial Deformation in Premature Infants

et al. 2014

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BACKGROUND: Frame rate (FR) of image acquisition is an important determinant of the reliability of 2-dimensional speckle tracking echocardiography (2DSTE)-derived myocardial strain. Premature infants have relatively high heart rates (HR). The aim was to analyze the effects of varying FR on the reproducibility of 2DSTE-derived right ventricle (RV) and left ventricle (LV) longitudinal strain (LS) and strain rate (LSR) in premature infants. METHODS: RV and LV LS and LSR were measured by 2DSTE in the apical 4-chamber view in 20 premature infants (26 ± 1 weeks) with HR 163 ± 13 bpm. For each subject, 4 sets of cine-loops were acquired at FR of <90, 90-110, 110-130, and >130 frames/s. Two observers measured LS and LSR. Inter- and intra-observer reproducibility was assessed using Bland Altman analysis, coefficient of variation, and linear regression. RESULTS: Intra-observer reproducibility for RV and LV LS was higher at FR >110 frames/s, and optimum at FR >130 frames/s. The highest inter-observer reproducibility for RV and LV LS were at FR >130 and > 110 frames/s, respectively. The highest reproducibility for RV and LV systolic and early diastolic LSR was at FR > 110 frames/s. FR/HR ratio >0.7 frames/s/bpm yielded optimum reproducibility for RV and LV deformation imaging. CONCLUSIONS: The reliability of 2DSTE-derived RV and LV deformation imaging in premature infants is affected by the FR of image acquisition. Reproducibility is most robust when cine-loops are obtained with FR/HR ratio between 0.7 – 0.9 frames/s/bpm, which likely results from optimal myocardial speckle tracking and mechanical event timing.

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“…Only infants who were breathing spontaneously in air, without clinical or echocardiographic evidence of pulmonary hypertension or congenital cardiac anomaly (including ventricular septal defect), were included. In view of potential limitations of the use of OA cases as controls, we additionally compared CDH group strain data to available existing published normative strain data (left ventricle [LV] longitudinal strain [LS], LV circumferential strain [CS], right ventricle [RV] LS) obtained in healthy newborn infants in the first 48 h of life (published controls group) [7, 8]. Study ethical approval was provided by the institutional Information Governance and Research Office.…”

Section: Methodsmentioning

confidence: 99%

Ventricular Dysfunction, Interdependence, and Mechanical Dispersion in Newborn Infants with Congenital Diaphragmatic Hernia

et al. 2019

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Background: Congenital diaphragmatic hernia (CDH) is an important cause of mortality and morbidity in the neonatal period. Pulmonary hypertension and pulmonary hypoplasia are key pathological findings. Cardiac function may also be an important determinant of disease severity, prognostic indicator, and therapeutic target in CDH. Objective: The aim of this study was to assess ventricular mechanics and synchrony in infants with CDH and controls using speckle tracking echocardiography (STE). Methods: Retrospective analysis was performed of echocardiograms obtained in the first 48 h of life in 27 infants with CDH and 20 controls. STE-derived longitudinal strain (LS) was measured in the right and left ventricles (RV, LV). Circumferential strain (CS) and radial strain (RS) were additionally measured in the LV. Mechanical dispersion (MD), a measure of synchrony, was assessed by calculation of the standard deviation of time to peak systolic strain in six ventricular segments. Results: RV LS and LV LS, LV CS, and LV RS were significantly reduced in CDH compared to controls. In the LV free wall, LS and RS were significantly reduced in CDH. LV LS correlated significantly with RV LS in CDH cases (r² = 0.37, p = 0.002), but not controls (r² = 0.19, p = 0.06). LV LS also correlated with LV MD in CDH (r² = 0.25, p = 0.01) but not controls (r² = 0.02, p = 0.54). Conclusions: Global impairment of RV and LV systolic function are present in newborn infants with CDH and are associated with primary left ventricular dysfunction, ventricular interdependence, and MD.

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Longitudinal follow-up of ventricular performance in healthy neonates

Cited by 21 publications

References 28 publications

Circumferential and radial deformation assessment in premature infants: Ready for primetime?

Circumferential and radial deformation assessment in premature infants: Ready for primetime?

Effects of Frame Rate on Two‐Dimensional Speckle Tracking–Derived Measurements of Myocardial Deformation in Premature Infants

Ventricular Dysfunction, Interdependence, and Mechanical Dispersion in Newborn Infants with Congenital Diaphragmatic Hernia

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