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Updated: Jun 7, 2026
Hemodynamic Precision in the Neonatal Intensive Care Unit using Targeted Neonatal Echocardiography
Published on: January 27, 2023
Assessment of myocardial function in neonates using tissue Doppler imaging
R J S Negrine1, A Chikermane, J G C Wright
1Neonatal Intensive Care Unit, Birmingham Women's Hospital, UK. rjsneg@doctors.org.uk
Insights
Tissue Doppler imaging (TDI) effectively measured neonatal myocardial velocities. Higher gestational age correlated with increased velocities and improved cardiac function, indicated by lower E/E' ratios in neonates.
Area of Science:
- Neonatal cardiology
- Pediatric echocardiography
- Cardiac physiology
Background:
- Assessing neonatal cardiac function is crucial for early diagnosis and management.
- Standard echocardiography provides valuable hemodynamic data, but myocardial tissue velocities offer further insight.
Purpose of the Study:
- To evaluate the feasibility and findings of tissue Doppler imaging (TDI) for measuring left and right ventricular myocardial velocities in neonates within the first 24 hours of life.
- To assess the relationship between gestational age and myocardial velocities (S', E', A') and the E/E' ratio.
Main Methods:
- Prospective study involving 43 neonates categorized by gestational age: term, preterm (30-36 weeks), and very preterm (<30 weeks).
- Tissue Doppler imaging (TDI) was used to measure peak systolic (S'), early diastolic (E'), and late diastolic (A') myocardial velocities.
- Standard echocardiography was performed concurrently, and the E/E' ratio was calculated for both ventricles.
Main Results:
- Myocardial velocities demonstrated a positive correlation with increasing gestational age.
- Right ventricular myocardial velocities were significantly higher than left ventricular velocities.
- The E/E' ratio decreased with increasing gestational age, with higher left E/E' ratios observed across all groups.
Conclusions:
- Tissue Doppler imaging (TDI) is a feasible technique for assessing myocardial velocities in preterm neonates.
- Increasing gestational age is associated with enhanced myocardial velocities and improved diastolic function (lower E/E' ratio).
- TDI provides valuable supplementary information on neonatal cardiac function when used with standard echocardiography.
Objective:
To measure the left and right ventricular myocardial velocities using tissue Doppler imaging (TDI) in the first 24 h of life in neonates.
Design:
Left and right ventricular peak systolic (S'), early diastolic (E') and late diastolic (A') myocardial velocities were measured using TDI alongside standard echocardiography (including peak diastolic atrioventricular flow, E). E/E' ratio was calculated for both ventricles.
Setting:
UK neonatal intensive care unit.
Patients:
43 neonates were prospectively recruited into three groups: term (n=16), preterm (30-36 weeks, n=12) and very preterm (<30 weeks, n=15).
Results:
Myocardial velocities increased with increasing gestation. Right ventricular velocities were significantly greater than left. E/E' ratio decreased with increasing gestation. Left E/E' ratio was higher than right in each group.
Conclusions:
TDI is feasible in preterm neonates and enables the acquisition of myocardial velocities. With increasing gestation, higher myocardial velocities and lower E/E' ratios were found. The addition of TDI to standard neonatal echocardiography may provide additional information about cardiac function.
