Ventricular dominance patterns in preterm infants

Schmer, V; Mogos, C; Gudavalli, Madhu; Sutija, Vesna G.; Tugertimur, Aykut

doi:10.1515/jpm.1999.040

Cited by 4 publications

(1 citation statement)

References 7 publications

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“…Newer imaging data [21] showed that the indexed mass of the left ventricle in GA weeks 29 to 37 de- clined more rapidly than the mass of the right ventricle consistent with a transition from LV dominance toward RV dominance. These findings of initial LV dominance changing to RV dominance toward term have been previously reported [22][23][24] although some discrepancies exist [25]. However, the anatomical and hemodynamic changes after birth are well described [4,22] and consistently show a switch toward LV dominance reflecting the transition from neonatal circulation with closure of the ductus arteriosus and foramen ovale as well as marked changes in pulmonary hemodynamics.…”

Section: -28 Dayssupporting

confidence: 62%

The Evolution of the Neonatal QRS Axis during the First Four Weeks of Life

et al. 2021

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Background: The QRS axis represents the sum and orientation of the ventricular depolarization. Accurate interpretation of abnormalities in the QRS axis may facilitate early diagnosis of heart disease in newborns. We aimed at describing the evolution of the QRS axis during the first 4 weeks of life and provide reference values from healthy newborns. Methods: The Copenhagen Baby Heart Study is a prospective general population study that offered cardiac evaluation during the first month of life to all newborns delivered in the Copenhagen area. Results: Electrocardiograms from 12,317 newborns (52% boys; mean age 12 days) with normal echocardiograms were included. The median QRS axis was 119° at the ages 0–7 days and shifted leftward to 102° at the ages 22–28 days (p < 0.001). We found that girls had a significantly less pronounced right-shifted axis than boys (p < 0.001) and that increasing gestational age (GA) was associated with a more pronounced right-shifted axis (p < 0.05). Infant size did not affect the axis (p > 0.05). Only 0.5% had an axis within the interval 0 to −90° and 1.1% in the interval +240 to +30°. Conclusions: The QRS axis showed a gradual leftward-shift during the first 4 weeks of life and was affected by sex and GA but unaffected by infant size. Less than 1% of the newborns had a QRS axis between 0 and −90°. This study represents updated reference values, which may facilitate the clinical handling of newborns.

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Section: -28 Dayssupporting

confidence: 62%

The Evolution of the Neonatal QRS Axis during the First Four Weeks of Life

et al. 2021

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Precordial ECG Amplitudes in the Days After Birth: Electrocardiographic Changes During Transition from Fetal to Neonatal Circulation

et al. 2021

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Gestational Age and Neonatal Electrocardiograms

et al. 2021

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OBJECTIVES Interpretation of the neonatal electrocardiogram (ECG) is challenging due to the profound changes of the cardiovascular system in this period. We aimed to investigate the impact of gestational age (GA) on the neonatal ECG and create GA-specific reference values. METHODS The Copenhagen Baby Heart Study is a prospective general population study that offered cardiac evaluation of neonates. ECGs and echocardiograms were obtained and systematically analyzed. GA, weight, height, and other baseline variables were registered. RESULTS We included 16 462 neonates (52% boys) with normal echocardiograms. The median postnatal age was 11 days (range 0 to 30), and the median GA was 281 days (range 238 to 301). Analyzing the ECG parameters as a function of GA, we found an effect of GA on almost all investigated ECG parameters. The largest percentual effect of GA was on heart rate (HR; 147 vs 139 beats per minute), the QRS axis (103° vs 116°), and maximum R-wave amplitude in V1 (R-V1; 0.97 vs 1.19 mV) for GA ≤35 vs ≥42 weeks, respectively. Boys had longer PR and QRS intervals and a more right-shifted QRS axis within multiple GA intervals (all P < .01). The effect of GA generally persisted after multifactorial adjustment. CONCLUSIONS GA was associated with significant differences in multiple neonatal ECG parameters. The association generally persisted after multifactorial adjustment, indicating a direct effect of GA on the developing neonatal cardiac conduction system. For HR, the QRS axis, and R-V1, the use of GA-specific reference values may optimize clinical handling of neonates.

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Ventricular dominance patterns in preterm infants

Abstract: A healthy full term infant is born with RV dominance. LV dominance with a trend toward RV dominance with increasing gestational age was found in preterm infants by EKG and echo criteria.

Cited by 4 publications

References 7 publications

The Evolution of the Neonatal QRS Axis during the First Four Weeks of Life

The Evolution of the Neonatal QRS Axis during the First Four Weeks of Life

Precordial ECG Amplitudes in the Days After Birth: Electrocardiographic Changes During Transition from Fetal to Neonatal Circulation

Gestational Age and Neonatal Electrocardiograms

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