Related Experiment Video
Updated: May 12, 2026
Echocardiographic Characterization of Left Ventricular Structure, Function, and Coronary Flow in Neonate Mice
Published on: April 7, 2022
Myocardial function in premature infants: a longitudinal observational study
Beate Horsberg Eriksen1, Eirik Nestaas, Torstein Hole
1Department of Paediatrics, Møre and Romsdal Hospital Trust, Ålesund Hospital, Ålesund, Norway.
Insights
Atrioventricular tissue Doppler velocities in premature infants increase with age, correlating with gestational and postnatal age. Right ventricle function matures more rapidly than left ventricle function.
Area of Science:
- Neonatal cardiology
- Pediatric echocardiography
- Fetal and neonatal physiology
Background:
- Myocardial function in premature infants is influenced by gestational and chronological age.
- Longitudinal assessment of cardiac function is crucial during neonatal transition.
- Atrioventricular tissue Doppler imaging provides insights into myocardial performance.
Purpose of the Study:
- To investigate longitudinal changes in atrioventricular tissue Doppler velocities in premature infants.
- To assess these changes during the neonatal transitional period and at expected term.
- To evaluate the reproducibility of these echocardiographic measurements.
Main Methods:
- Prospective, observational, longitudinal cohort study.
- Involved 55 premature infants (gestational age 31-35 weeks).
- Pulsed-wave atrioventricular annulus tissue Doppler velocities (S', E', A') measured on days 1, 2, 3, and at expected term.
Main Results:
- All measured velocities significantly increased from the neonatal period to expected term (p<0.001).
- Gestational age and postnatal age correlated significantly with several tissue Doppler velocities.
- Right ventricle velocities showed a more pronounced increase with maturation compared to left ventricle velocities.
Conclusions:
- Atrioventricular tissue Doppler velocities in premature infants are associated with gestational and postnatal age, and ventricular size.
- Postnatal maturation leads to greater increases in right ventricle velocities than left ventricle velocities.
- The degree of E'/A' fusion impacts diastolic tissue Doppler velocities and requires reporting.
Objectives:
Gestational and chronological age may have an impact on myocardial function. We studied the longitudinal changes of the atrioventricular tissue Doppler velocities in premature infants through the neonatal transitional period and at expected term and explored the reproducibility of the measurements.
Design:
Prospective, observational and longitudinal cohort study.
Setting:
Two-centre study, from a secondary and a tertiary neonatal intensive care unit.
Participants:
55 infants (29 males) with gestational age 31-35 weeks and birth weight 1127-2836 grams.
Primary And Secondary Outcome Measures:
Pulsed-wave atrioventricular left, septum and right ventricular annulus tissue Doppler systolic (S'), early diastolic (E') and late diastolic (A') velocities measured by repeated echocardiographic examinations days 1, 2 and 3 and at expected term.
Results:
All velocities increased significantly from the neonatal period to expected term (p<0.001). We found a significant correlation between gestational age and right-sided S', E' and A' on day 1 (Pearson correlation 0.32-0.46, p<0.05), for S' in all three walls and septal E' and A' on day 2 (Pearson correlation 0.27-0.49, p<0.05). There was a moderate linear correlation between left ventricle end-diastolic length and septal and right S' at term and for septal E' and A' at day 1 (Pearson correlation 0.30-0.56, p<0.05). We found no correlation between heart rate and tissue Doppler velocities when controlling for the effect of fusion. Continuous positive airway pressure showed moderate effect where as persistence of the ductus arteriosus showed no effect on the tissue Doppler velocities. The E'/A' relationship was consistently reversed throughout the study with frequently fused diastolic tissue velocity signals.
Conclusions:
Pulsed-wave atrioventricular annulus tissue Doppler velocities were related to gestational age, postnatal age and ventricular size. Right ventricle velocities showed more pronounced increase with postnatal maturation than left ventricle velocities. The degree of E'/A' fusion influenced the diastolic tissue Doppler velocities and should be reported if present.
