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High-frequency High-resolution Echocardiography: First Evidence on Non-invasive Repeated Measure of Myocardial Strain, Contractility, and Mitral Regurgitation in the Ischemia-reperfused Murine Heart
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Myocardial dysfunction in neonatal sepsis: a tissue Doppler imaging study.

Hesham E Abdel-Hady1, Mohamed K Matter, Mohamed M El-Arman

  • 1Neonatal Intensive Care Unit, Mansoura University Children's Hospital, Mansoura, Egypt. hehady@yahoo.com

Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies
|July 5, 2011
PubMed
Summary

Neonatal sepsis causes myocardial dysfunction, detectable by tissue Doppler imaging. Elevated cardiac troponin T levels in septic infants may indicate poor prognosis.

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Area of Science:

  • Neonatal cardiology
  • Pediatric critical care medicine
  • Echocardiography

Background:

  • Neonatal sepsis can lead to significant cardiovascular compromise.
  • Assessing myocardial performance in septic neonates is crucial for timely intervention.
  • Conventional echocardiography may not be sensitive enough to detect early myocardial dysfunction.

Purpose of the Study:

  • To evaluate myocardial performance in full-term infants with sepsis.
  • To correlate myocardial function with serum cardiac troponin T levels.
  • To compare the sensitivity of tissue Doppler imaging versus conventional echocardiography in detecting sepsis-induced myocardial dysfunction.

Main Methods:

  • Prospective case-control study involving 20 septic and 20 nonseptic full-term neonates.
  • Utilized conventional echocardiography and tissue Doppler imaging (TDI).
  • Measured serum cardiac troponin T concentrations.

Main Results:

  • Septic neonates exhibited significantly impaired myocardial function, indicated by higher Tei indexes and lower peak annular systolic velocities on TDI.
  • Serum cardiac troponin T concentrations were markedly elevated in septic infants and correlated with Tei indexes and reduced systolic velocities.
  • Higher cardiac troponin T and left ventricular Tei index were observed in non-survivors.

Conclusions:

  • Neonatal sepsis is associated with both systolic and diastolic myocardial dysfunction.
  • Tissue Doppler imaging is a sensitive tool for detecting myocardial dysfunction in septic neonates, potentially more so than conventional echocardiography.
  • Serum cardiac troponin T and left ventricular Tei index may serve as prognostic markers in neonatal sepsis.