Neonatal cardiac dysfunction in intrauterine growth restriction
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Published on: June 29, 2013
Sotirios Fouzas1, Ageliki A Karatza2, Periklis A Davlouros3
11] Neonatal Intensive Care Unit, University Hospital of Patras, University of Patras Medical School, Patras, Greece [2] Department of Pediatrics, University Hospital of Patras, University of Patras Medical School, Patras, Greece.
Insights
Intrauterine growth restriction (IUGR) in newborns leads to cardiac changes and impaired cardiovascular adaptation. IUGR infants show altered myocardial function compared to appropriate-for-gestational age (AGA) infants postnatally.
Area of Science:
- Neonatal cardiology
- Fetal development
- Cardiovascular physiology
Background:
- Early postnatal cardiovascular effects of intrauterine growth restriction (IUGR) are not fully understood.
- Investigating IUGR's impact on neonatal myocardial function and adaptation is crucial.
Purpose of the Study:
- To evaluate the effect of IUGR on neonatal myocardial function.
- To assess cardiovascular adaptation to extrauterine life in IUGR neonates.
Main Methods:
- Compared echocardiographic parameters in 30 IUGR and 30 appropriate-for-gestational age (AGA) neonates.
- Utilized conventional and tissue Doppler echocardiography on postnatal days 2 and 5.
Main Results:
- IUGR neonates exhibited relative interventricular septum hypertrophy and left ventricular dilatation.
- Increased left myocardial performance index (MPI) was observed in IUGR infants.
- IUGR neonates showed altered patterns in left ventricular stroke volume, cardiac output, MPI, and heart rate compared to AGA infants, with decreased cardiac output.
Conclusions:
- IUGR neonates present with cardiac morphological changes and subclinical myocardial dysfunction.
- These alterations contribute to an altered cardiovascular adaptation pattern after birth.
Background:
The early postnatal cardiovascular consequences of intrauterine growth restriction (IUGR) have not been completely elucidated. This study aimed to evaluate the effect of IUGR on neonatal myocardial function and cardiovascular adaptation to extrauterine life.
Methods:
Conventional and tissue Doppler echocardiographic parameters were compared on the second and fifth postnatal day between 30 IUGR and 30 appropriate-for-gestational age (AGA) neonates.
Results:
IUGR neonates presented relative interventricular septum (IVS) hypertrophy (IVS to left ventricular (LV) posterior wall diastolic ratio: median IUGR-AGA difference of 0.05 (interquartile range: 0.04-0.06); P = 0.020), relative LV dilatation (wall thickness to end-diastolic LV dimension difference of 0.12 (0.06-0.16); P = 0.012), and increased left myocardial performance index (MPI difference of 0.19 (0.05-0.28); P = 0.012). Repeated measurements ANOVA revealed a different pattern of change in LV stroke volume (LVSV; P < 0.001), LV cardiac output (LVCO; P < 0.001), MPI (P < 0.001), and heart rate (HR; P = 0.025) between AGA and IUGR infants. From the second to the fifth postnatal day, AGA neonates presented a decrease in MPI and HR with an increase in LVSV and LVCO. IUGR neonates failed to achieve similar changes in MPI, HR, and LVSV, whereas their LVCO decreased.
Conclusion:
IUGR neonates present changes in cardiac morphology and subclinical myocardial dysfunction, which may result in an altered pattern of cardiovascular adaptation to extrauterine life.
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