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Published on: January 27, 2023
Longitudinal follow-up of ventricular performance in healthy neonates
Liselotte M Klitsie1, Arno A W Roest, Monique C Haak
1Department of Pediatric Cardiology, Leiden University Medical Center, PO Box 9600, Room J6S-208, 2300RC Leiden, The Netherlands.
Insights
Echocardiography shows left ventricular (LV) tissue Doppler imaging (TDI) parameters increase with cardiac growth in healthy infants up to two months. Speckle tracking strain parameters remained stable, suggesting their value in assessing LV systolic performance during neonatal growth.
Area of Science:
- Neonatal cardiology
- Pediatric cardiovascular imaging
- Fetal and neonatal physiology
Background:
- Echocardiographic parameters for assessing cardiac function in neonates are evolving.
- Limited follow-up data exists for newly introduced echocardiographic techniques in healthy infants.
Purpose of the Study:
- To prospectively evaluate left ventricular (LV) tissue Doppler imaging (TDI) and speckle tracking strain parameters in healthy neonates up to two months post-birth.
- To describe the changes in these parameters during early infant cardiac growth.
Main Methods:
- A longitudinal follow-up study included 28 healthy newborns.
- Transthoracic echocardiography was performed at 1-3 days, 3 weeks, and 6-7 weeks after birth.
- Measurements included LV mass (LVM), TDI velocities (S', E', A'), and speckle tracking strain parameters.
Main Results:
- Left ventricular mass (LVM) significantly increased from 7.6 ± 2.4g to 12.4 ± 3.2g (p = 0.002).
- LV and interventricular septum (IVS) systolic (S') and diastolic (E') TDI parameters significantly increased between early and later follow-up points (p < 0.001).
- Global peak longitudinal, radial, and circumferential strain parameters showed no significant changes during follow-up.
Conclusions:
- LV systolic and diastolic TDI parameters increase significantly in healthy infants up to two months, likely related to cardiac growth.
- Speckle tracking strain parameters remained stable, indicating their potential utility for evaluating LV systolic performance independent of growth during the neonatal period.
Background:
Specific follow-up of newly introduced echocardiographic parameters in healthy neonates and infants is limited.
Aim:
To prospectively describe follow-up of left ventricular (LV) tissue Doppler imaging (TDI) and speckle tracking strain parameters in healthy subjects up to two months after birth.
Design:
This is a longitudinal follow-up study.
Subjects:
Twenty-eight (10 male) healthy newborns were included and underwent transthoracic echocardiography 1-3 days, 3 weeks and 6-7 weeks after birth.
Outcome Measures:
In each echocardiogram, parameters describing cardiac growth, including LV mass (LVM), were assessed. Additionally, TDI derived peak systolic velocity (S') and peak early (E') and late (A') diastolic velocities were assessed in the basal LV free wall and interventricular septum (IVS). Finally LV longitudinal, radial and circumferential global peak strain parameters were assessed using speckle tracking strain imaging.
Results:
LVM significantly increased during follow-up (7.6 ± 2.4 versus 12.4 ± 3.2g, p = 0.002). Similarly at 1-3 days versus 6-7 weeks after birth, an increase in LV and IVS systolic (LV S' 4.1 ± 1.5 versus 6.3 ± 1.5 cm/s, p = 0.001; IVS S' 3.6 ± 0.9 versus 6.4 ± 1.3 cm/s, p < 0.001) and diastolic (LV E' 6.1 ± 2.2 versus 9.7 ± 2.9 cm/s, p = 0.002; IVS E' 5.1 ± 1.4 versus 10.7 ± 3.3 cm/s, p < 0.001) TDI parameters was observed. In contrast, global peak longitudinal, radial and circumferential strain parameters did not significantly change during follow-up.
Conclusions:
A significant increase in LV systolic and diastolic TDI parameters was observed up to two months after birth. Yet this increase may be (cardiac) growth-dependent. No significant changes were observed in speckle tracking strain derived global peak strain parameters; this may render the technique particularly valuable in evaluation of LV systolic performance during periods of significant growth, such as the neonatal period.
