Left Ventricular Rotational Mechanics in Preterm Infants Less Than 29 Weeks’ Gestation over the First Week after Birth

2015 ◽  
Vol 28 (7) ◽  
pp. 808-817.e1 ◽  
Author(s):  
Adam James ◽  
John David Corcoran ◽  
Luc Mertens ◽  
Orla Franklin ◽  
Afif EL-Khuffash
Keyword(s):  
Preterm Infants ◽  
Left Ventricular ◽  
Rotational Mechanics

scholarly journals Comparison of left ventricular rotational mechanics between term and extremely premature infants over the first week of age

Open Heart ◽  
2021 ◽  
Vol 8 (1) ◽  
pp. e001458
Author(s):  
Aisling Smith ◽  
Neidin Bussmann ◽  
Phillip Levy ◽  
Orla Franklin ◽  
Naomi McCallion ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Premature Infants ◽  
Left Ventricular ◽  
Strong Positive Correlation ◽  
Term Infants ◽  
Time Points ◽  
Apical Rotation ◽  
Extremely Preterm ◽  
Basal Rotation ◽  
Rotational Mechanics

ObjectiveLeft ventricle (LV) rotational mechanics is an emerging tool to characterise LV function, but warrants further evaluation in neonates. The aim of this study was to compare LV rotational mechanics between term and extremely preterm babies over the first week of age.MethodsIn this prospective study, we serially assessed LV rotational parameters in 50 term infants and compared them with a historical dataset of 50 preterm infants born <29 weeks gestation. LV basal and apical rotation, LV twist, LV twist/untwist rate and torsion were derived using two-dimensional speckle tracking echocardiography at three time points over the first week of age.ResultsThere was no change in LV twist, LV torsion, basal rotation or apical rotation in term infants over the study period (all p>0.05). LV twist and torsion were higher in preterm infants, and increased over time. In preterm infants, basal rotation evolved from anticlockwise to clockwise rotation. Apical rotation remained anticlockwise in both groups (all p>0.05). LV twist rate (LVTR) and untwist rate was higher in preterm infants and increased over the three time points (all p>0.05). There was a strong positive correlation between LV torsion and LV untwist rate (LVUTR) in the entire cohort during the third scan.ConclusionTerm infants exhibit minimal LV twist which remains unchanged over the first week of age. This is in contrast to premature infants who demonstrate increasing indices of twist, torsion, LVTR and LVUTR over the first week, likely as a compensatory mechanism for reduced LV compliance.

scholarly journals Prediction of Extubation Readiness Using Transthoracic Ultrasound in Preterm Infants

2020 ◽  
Author(s):  
Reem M. Soliman ◽  
Yasser Elsayed ◽  
Reem N. Said ◽  
Abdulaziz M. Abdulbaqi ◽  
Rania H. Hashem ◽  
...  
Keyword(s):  
Pulmonary Artery ◽  
Preterm Infants ◽  
Pulmonary Artery Pressure ◽  
Neonatal Intensive Care ◽  
Ductus Arteriosus ◽  
Interventricular Septum ◽  
Area Under The Curve ◽  
Left Ventricular ◽  
Predictive Values ◽  
Artery Pressure

ABSTRACTObjectiveTo test the hypothesis that a lung ultrasound severity score (LUSsc) and assessment of left ventricular eccentricity index of the interventricular septum (LVEI) by focused heart ultrasound can predict extubation success in mechanically ventilated preterm infants with respiratory distress syndrome (RDS).DesignProspective observational study of premature infants <34 weeks’ of gestation age supported with mechanical ventilation due to RDS. LUSsc and LVEI were performed on postnatal days 3 and 7 by an investigator who was masked to infants’ ventilator parameters and clinical conditions. RDS was classified based on LUSsc into mild (score 0–9) and moderate-severe (score 10–18). A receiver operator curve was constructed to assess the ability to predict extubation success. Pearson’s correlation was performed between LVEI and pulmonary artery pressure (PAP).SettingLevel III neonatal intensive care unit, Cairo, Egypt.ResultsA total of 104 studies were performed to 66 infants; of them 39 had mild RDS (LUSsc 0–9) and 65 had moderate-severe RDS (score ≥10). LUSsc predicted extubation success with a sensitivity and a specificity of 91% and 69%; the positive and negative predictive values were 61% and 94%, respectively. Area under the curve (AUC) was 0.83 (CI: 0.75-0.91). LVEI did not differ between infants that succeeded and failed extubation. However, it correlated with pulmonary artery pressure during both systole (r=0.62) and diastole (r=0.53) and with hemodynamically significant patent ductus arteriosus (r=0.27 and r=0.46, respectively).ConclusionLUSsc predicts extubation success in preterm infants with RDS whereas LVEI correlates with high PAP.

scholarly journals Left ventricular pumping during the transition–adaptation sequence in preterm infants: impact of the patent ductus arteriosus

2018 ◽  
Vol 83 (5) ◽  
pp. 1016-1023 ◽  
Author(s):  
Sigrid Baumgartner ◽  
Monika Olischar ◽  
Martin Wald ◽  
Tobias Werther ◽  
Angelika Berger ◽  
...  
Keyword(s):  
Patent Ductus Arteriosus ◽  
Preterm Infants ◽  
Ductus Arteriosus ◽  
Left Ventricular ◽  
Patent Ductus

scholarly journals Maturational patterns of left ventricular rotational mechanics in pre-term infants through 1 year of age

2020 ◽  
Vol 30 (9) ◽  
pp. 1238-1246
Author(s):  
Gloria C. Lehmann ◽  
Philip T. Levy ◽  
Meghna D. Patel ◽  
Timothy Sekarski ◽  
HongJie Gu ◽  
...  
Keyword(s):  
Repeated Measures ◽  
Neonatal Period ◽  
Ductus Arteriosus ◽  
Left Ventricular ◽  
Term Infants ◽  
Apical Rotation ◽  
Cardiopulmonary Complications ◽  
Rotational Mechanics ◽  
The Impact ◽  
Over Time

AbstractBackground:Pre-mature birth impacts left ventricular development, predisposing this population to long-term cardiovascular risk. The aims of this study were to investigate maturational changes in rotational properties from the neonatal period through 1 year of age and to discern the impact of cardiopulmonary complications of pre-maturity on these measures.Methods:Pre-term infants (<29 weeks at birth, n = 117) were prospectively enrolled and followed to 1-year corrected age. Left ventricular basal and apical rotation, twist, and torsion were measured by two-dimensional speckle-tracking echocardiography and analysed at 32 and 36 weeks post-menstrual age and 1-year corrected age. A mixed random effects model with repeated measures analysis was used to compare rotational mechanics over time. Torsion was compared in infants with and without complications of cardiopulmonary diseases of pre-maturity, specifically bronchopulmonary dysplasia, pulmonary hypertension, and patent ductus arteriosus.Results:Torsion decreased from 32 weeks post-menstrual age to 1-year corrected age in all pre-term infants (p < 0.001). The decline from 32 to 36 weeks post-menstrual age was more pronounced in infants with cardiopulmonary complications, but was similar to healthy pre-term infants from 36 weeks post-menstrual age to 1-year corrected age. The decline was due to directional and magnitude changes in apical rotation over time (p < 0.05).Conclusion:This study tracks maturational patterns of rotational mechanics in pre-term infants and reveals torsion declines from the neonatal period through 1 year. Cardiopulmonary diseases of pre-maturity may negatively impact rotational mechanics during the neonatal period, but the myocardium recovers by 1-year corrected age.

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