Normative Left Ventricular M-Mode Echocardiographic Values in Preterm Infants up to 2 kg

Choudhry, Swati; Salter, Amber; Cunningham, Trevor; Levy, Philip; Nguyen, Hoang H.; Wallendorf, Michael; Singh, Gautam K.; Johnson, Mark C.

doi:10.1016/j.echo.2017.04.010

Cited by 15 publications

(17 citation statements)

References 49 publications

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“…Furthermore, there seems to be no true difference according to whether the cardiac parameters are indexed for TC or BSA. This is similar to previous findings that neonatal BSA and body weight are almost equally good indexing methods 12 .…”

Section: Discussionsupporting

confidence: 92%

“…Assessing gestation and fetal growth is key when examining prenatal effects on the cardiovascular phenotype at birth 10 . The definitions of abnormal fetal growth vary, and although body surface area (BSA) is the recommended method for adjusting cardiac geometry for body size in the child 11 , there is a lack of consensus concerning how geometry should be adjusted in preterm or term neonates 12 . For instance, left ventricular volume has been suggested to be best adjusted by BSA 1.50 or BSA 1.38 and the use of neonatal Z ‐scores, based on a normal birth weight or BSA range, might not be appropriate for neonates with abnormal body size at birth 13,14 .…”

Section: Introductionmentioning

confidence: 99%

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Differences in cardiac geometry in relation to body size among neonates with abnormal prenatal growth and body size at birth

Olander

Sundholm

Ojala

et al. 2020

Ultrasound in Obstet & Gyne

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Objectives Both excessive and restricted fetal growth are associated with changes in cardiac geometry and function at birth. There are significant issues when indexing cardiac parameters for body size in the neonatal period. The aims of this study were to determine to what extent cardiac geometry is dependent on body size in term and preterm neonates with restricted or excessive fetal growth and how this is affected by adiposity. Methods This was a cross‐sectional study of neonates born between 31 and 42 weeks of gestation, divided into three groups: (1) small‐for‐gestational age (SGA, birth weight > 2 SD below the mean); (2) large‐for‐gestational age (LGA, birth weight > 2 SD above the mean); and (3) appropriate‐for‐gestational‐age controls (AGA, birth weight ≤ 2 SD from the mean). Cardiac geometry and function were compared between the study groups, adjusting for body size. The potential impact of infant adiposity and maternal disease was assessed. Results In total, 174 neonates were included, of which 39 were SGA, 45 were LGA and 90 were AGA. Body size was reflected in cardiac dimensions, with differences in cardiac dimensions disappearing between the SGA and AGA groups when indexed for body surface area (BSA) or thoracic circumference. The same was true for the differences in atrial and ventricular areas between the LGA and AGA groups. However, left ventricular inflow and outflow tract dimensions did not follow this trend as, when indexed for BSA, they were associated negatively with adiposity, resulting in diminished dimensions in LGA compared with AGA and SGA neonates. Adiposity was associated positively with left ventricular mass, right ventricular length and area and right atrial area. The SGA group showed increased right ventricular fractional area change, possibly reflecting differences in the systolic function of the right ventricle. We found evidence of altered diastolic function between the groups, with the mitral valve inflow E‐ to lateral E′‐wave peak velocity ratio being increased in the LGA group and decreased in the SGA group. Conclusions Cardiac geometry is explained by body size in both term and preterm AGA and SGA infants. However, the nature of the relationship between body size and cardiac dimensions may be influenced by adiposity in LGA infants, leading to underestimation of left ventricular inflow and outflow tract dimensions when adjusted for BSA. Adjustments for thoracic circumference provide similar results to those for BSA. Copyright © 2020 ISUOG. Published by John Wiley & Sons Ltd.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Differences in cardiac geometry in relation to body size among neonates with abnormal prenatal growth and body size at birth

Olander

Sundholm

Ojala

et al. 2020

Ultrasound in Obstet & Gyne

View full text Add to dashboard Cite

show abstract

“… 18 LV morphology was assessed with LV mass indexed (LVMi) and relative wall thickness (RWT). 19 RV function was assessed with fractional area of change (FAC), 20 tricuspid annular plane systolic excursion (TAPSE), 21 and RV longitudinal strain and strain rate. 12 RV morphology was characterized by RV areas in systole and diastole and RV linear dimensions.…”

Section: Methodsmentioning

confidence: 99%

Cardiac Performance in the First Year of Age Among Preterm Infants Fed Maternal Breast Milk

et al. 2021

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IMPORTANCE There is a beneficial association between human breast milk exposure in the neonatal period and cardiac mechanics in adults who were born preterm. It is unknown whether this benefit is apparent in infants in the first year of age.OBJECTIVE To test the hypothesis that higher consumption of mother's own milk in preterm infants is associated with enhanced cardiac performance during the first year of age. DESIGN, SETTING, AND PARTICIPANTSThis cross-sectional study of cardiac and nutritional data at an academic medical center included 80 individuals born preterm and 100 individuals in the control group born full-term. All births were between 2011 and 2013. Two-dimensional echocardiograms were performed at 32 weeks' and 36 weeks' postmenstrual age and at 1 year's corrected age in individuals born preterm and at 1 month and 1 year of age in individuals born fullterm. Statistical analysis was performed from January to May 2021. EXPOSURES Consumption of mother's own milk. MAIN OUTCOMES AND MEASURESMain study outcomes included echocardiography measures of right and left ventricle longitudinal strain (function), left ventricle mass index and right ventricular areas (morphology), and pulmonary vascular resistance (pulmonary hemodynamics) at age 1 year. RESULTSOf 180 infants included in the study, 97 (54%) were Black infants and 89 (49%) were female infants. Among the 80 infants born in the preterm cohort, 43 (54%) were female infants and 43 (54%) were Black infants. The median gestational age at birth of the preterm infants was 27.0 weeks (interquartile range, 26.0-28.0 weeks) and the median birth weight was 960 g (interquartile range, 800-1138). For each week of exposure to mother's own milk, preterm infants had greater magnitudes of right ventricular strain (eg,

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“…8,9 Furthermore, recent work demonstrated that sex specific centile curves using left ventricular M-mode echocardiographic values indexed to weight alone were actually similar to curves generated using length and body surface. 49 We therefore elected to present percentile charts (mean +/− standard deviation) using linear regression to assess the independent effect of postnatal age (in weeks) and weight (at the time of echocardiography) on each PAAT measurement, while adjusting for gestational age at birth and gender. There are many approaches to interpret these measures, but understanding both the advantages and limitations will serve to inform the clinician on how PAAT could be an important variable during follow-up investigations of neonates at risk to develop pulmonary hypertension, as it has been shown for pediatric 8,50 and adult patients.…”

Section: Limitationsmentioning

confidence: 99%

Echocardiographic Assessment of Right Ventricular Afterload in Preterm Infants: Maturational Patterns of Pulmonary Artery Acceleration Time Over the First Year of Age and Implications for Pulmonary Hypertension

Patel

Breatnach

James

et al. 2019

Journal of the American Society of Echocardiography

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Background: Assessment of pulmonary hemodynamics is critical in the diagnosis and management of cardiopulmonary disease of premature infants, but reliable non-invasive indices of pulmonary hemodynamics in preterm infants are lacking. Since pulmonary artery acceleration time (PAAT) is a validated non-invasive method to assess right ventricular (RV) afterload in infants and children, we investigated the maturational changes of pulmonary artery acceleration time (PAAT) measures in preterm infants over the first year of age, and discerned the impact of typical cardiopulmonary abnormalities on the measures. Methods:In a prospective multi-center study of 239 preterm infants (<29 weeks at birth), PAAT was assessed at days 1, 2, 5-7, 32 and 36 weeks post-menstrual age, and at 1 year corrected age. To account for heart rate variability, PAAT was adjusted for right ventricular ejection time (PAAT/

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Normative Left Ventricular M-Mode Echocardiographic Values in Preterm Infants up to 2 kg

Cited by 15 publications

References 49 publications

Differences in cardiac geometry in relation to body size among neonates with abnormal prenatal growth and body size at birth

Differences in cardiac geometry in relation to body size among neonates with abnormal prenatal growth and body size at birth

Cardiac Performance in the First Year of Age Among Preterm Infants Fed Maternal Breast Milk

Echocardiographic Assessment of Right Ventricular Afterload in Preterm Infants: Maturational Patterns of Pulmonary Artery Acceleration Time Over the First Year of Age and Implications for Pulmonary Hypertension

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