Progression of Right Ventricular Systolic Dysfunction Detected by Myocardial Deformation Imaging in Asymptomatic Preterm Children

Kang, Soo Jung; Kim, Mi-Ra; Hwang, Seo Jung; Kim, Hyo Jin

doi:10.4250/jcu.2017.25.3.98

Cited by 4 publications

(7 citation statements)

References 26 publications

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“…The exact mechanism that explains why preterm infants have subclinical right ventricle dysfunction and alterations in right ventricle morphology that persists to 1 year of age is not yet known. We propose two theories that may explain this observation: 1) changes in postnatal loading conditions[26], and 2) loss of the third trimester myocardial structural programming[7]. The exposure of an immature preterm right ventricle to a sustained increase in hemodynamic load of postnatal circulation (increased right ventricle afterload), at a time in the development when the right ventricle primarily supports a low- resistance circulation, may induce myoarchitectural adaptation that can lead to changes in geometry, structure, and function, “a process known as ventricular remodeling”[27].…”

Section: Discussionmentioning

confidence: 99%

Persistence of right ventricular dysfunction and altered morphometry in asymptomatic preterm Infants through one year of age: Cardiac phenotype of prematurity

et al. 2019

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Introduction:Prematurity impacts myocardial development and may determine long-term outcomes. The objective of this study was to test the hypothesis that preterm neonates develop right ventricle dysfunction and adaptive remodelling by 32 weeks post-menstrual age that persists through 1 year corrected age.Materials and Methods:A subset of 80 preterm infants (born <29 weeks) was selected retrospectively from a prospectively enrolled cohort and measures of right ventricle systolic function and morphology by two-dimensional echocardiography were assessed at 32 weeks post-menstrual age and at 1 year of corrected age. Comparisons were made to 50 term infants at 1 month and 1 year of age. Sub-analyses were performed in preterm-born infants with bronchopulmonary dysplasia and/or pulmonary hypertension.Result:In both term and preterm infants, right ventricle function and morphology increased over the first year (p < 0.01). The magnitudes of right ventricle function measures were lower in preterm-born infants at each time period (p < 0.01 for all) and right ventricle morphology indices were wider in all preterm infants by 1 year corrected age, irrespective of lung disease. Measures of a) right ventricle function were further decreased and b) morphology increased through 1 year in preterm infants with bronchopulmonary dysplasia and/or pulmonary hypertension (p < 0.01).Conclusion:Preterm infants exhibit abnormal right ventricle performance with remodelling at 32 weeks post-menstrual age that persists through 1 year corrected age, suggesting a less developed intrinsic myocardial function response following preterm birth. The development of bronchopulmonary dysplasia and pulmonary hypertension leave a further negative impact on right ventricle mechanics over the first year of age.

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Section: Discussionmentioning

confidence: 99%

Persistence of right ventricular dysfunction and altered morphometry in asymptomatic preterm Infants through one year of age: Cardiac phenotype of prematurity

et al. 2019

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“…Peak longitudinal right atrial strain (PLRAS) and RV longitudinal peak systolic strain was obtained by using vector velocity imaging as previously described. 18) 19) Briefly, in the apical 4-chamber view, the endocardial borders of the RA and RV were manually traced and subsequently tracked using the velocity vector imaging software. PLRAS values of the lateral free wall, interatrial septum, and the roof of the RA were measured at end-systole and averaged.…”

Section: Methodsmentioning

confidence: 99%

“…We have previously reported the intraobserver and interobserver variability of peak RV longitudinal strain in preterm infants to be 20% and 21%, respectively. 19) The mean percentage error 20) was calculated to obtain the intraobserver and interobserver variabilities of PLRAS, as described previously. 19) One investigator repeated deformation analysis of PLRAS 4 weeks apart on 30 infants to evaluate intraobserver variability.…”

Section: Methodsmentioning

confidence: 99%

“… 19) The mean percentage error 20) was calculated to obtain the intraobserver and interobserver variabilities of PLRAS, as described previously. 19) One investigator repeated deformation analysis of PLRAS 4 weeks apart on 30 infants to evaluate intraobserver variability. Two investigators who were blinded to BPD severity status and clinical information performed deformation analysis of PLRAS separately on 30 infants to determine interobserver variability.…”

Section: Methodsmentioning

confidence: 99%

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Right Atrial Strain in Preterm Infants With a History of Bronchopulmonary Dysplasia

Kang

Jung

Hwang

et al. 2022

J Cardiovasc Imaging

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BACKGROUND Few studies have utilized right atrial (RA) strain to evaluate right ventricular (RV) diastolic dysfunction in preterm infants with bronchopulmonary dysplasia (BPD). We aimed to evaluate the associations of RA strain with BPD severity and respiratory outcomes in preterm infants with BPD. METHODS We retrospectively studied 153 infants with BPD born before 32 weeks of gestational age at CHA Bundang Medical Center. Peak longitudinal right atrial strain (PLRAS) was obtained using velocity vector imaging and compared among infants across BPD severity. Conventional echocardiographic parameters and clinical characteristics were also evaluated. RESULTS In infants with severe BPD, mean gestational age (27.4 ± 2.1 weeks) and mean birth weight (971.3 ± 305.8 g) were significantly smaller than in those with mild BPD (30.0 ± 0.9 weeks, 1,237.3 ± 132.2 g) and moderate BPD (29.6 ± 1.3 weeks, 1,203.2 ± 214.4 g). PLRAS was significantly lower in infants with severe BPD (26.3 ± 10.1%) than in those in the moderate BPD group (32.4 ± 10.9%) or mild BPD group (31.9 ± 8.3%). Tricuspid E/e′ and maximum RA volume index were similar across BPD severity. A decrease in PLRAS was significantly correlated with increased duration of mechanical ventilation duration; however, tricuspid E/e′ and maximum RA volume index were not. CONCLUSIONS Evaluating PLRAS with other parameters in infants with BPD might detect RV diastolic dysfunction. Longer follow-up and larger study populations may elucidate the association between PLRAS and respiratory outcomes in infants with BPD.

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“…Several studies have investigated cardiac function in the preterm population in the first months [17][18][19][20], at one year [21,22], at two years [23], and at school age [20,[24][25][26]. However, there is limited literature available that compares echocardiographic assessments between preschool-aged children with a history of prematurity and those born at full term.…”

Section: Introductionmentioning

confidence: 99%

Cardiac Mechanics Evaluation in Preschool-Aged Children with Preterm Birth History: A Speckle Tracking and 4D Echocardiography Study

Savio,

Sirico,

Mazzon

et al. 2024

JCM

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Background: The premature-born adult population is set to grow significantly, and prematurity has emerged as an important cardiovascular risk factor. We aimed to comprehensively assess cardiac mechanics and function in a cohort of ex-preterm preschoolers. Methods: Ex-preterm children (<30 weeks of gestation), aged 2 to 5 years, underwent transthoracic 2D, speckle-tracking, and 4D echocardiography. The findings were compared with 19 full-term children. Results: Our cohort of 38 children with prematurity history showed a normal morpho-functional echocardiographic assessment. However, compared to controls, the indexed 3D end-diastolic volumes of ventricular chambers were reduced (left ventricle 58.7 ± 11.2 vs. 67.2 ± 8.5 mL/m2; right ventricle 50.3 ± 10.4 vs. 57.7 ± 11 mL/m2; p = 0.02). Left ventricle global and longitudinal systolic function were worse in terms of fraction shortening (32.9% ± 6.8 vs. 36.5% ± 5.4; p = 0.05), ejection fraction (59.2% ± 4.3 vs. 62.3% ± 3.7; p = 0.003), and global longitudinal strain (−23.6% ± 2.4 vs. −25.5% ± 1.7; p = 0.003). Finally, we found a reduced left atrial strain (47.4% ± 9.7 vs. 54.9% ± 6.8; p = 0.004). Conclusions: Preschool-aged ex-preterm children exhibited smaller ventricles and subclinical impairment of left ventricle systolic and diastolic function compared to term children. Long-term follow-up is warranted to track the evolution of these findings.

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Progression of Right Ventricular Systolic Dysfunction Detected by Myocardial Deformation Imaging in Asymptomatic Preterm Children

Cited by 4 publications

References 26 publications

Persistence of right ventricular dysfunction and altered morphometry in asymptomatic preterm Infants through one year of age: Cardiac phenotype of prematurity

Persistence of right ventricular dysfunction and altered morphometry in asymptomatic preterm Infants through one year of age: Cardiac phenotype of prematurity

Right Atrial Strain in Preterm Infants With a History of Bronchopulmonary Dysplasia

Cardiac Mechanics Evaluation in Preschool-Aged Children with Preterm Birth History: A Speckle Tracking and 4D Echocardiography Study

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