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Published on: February 3, 2014
Serial assessment of right ventricular function using tissue Doppler imaging in preterm infants within 7 days of life
Masanori Murase1, Takeshi Morisawa2, Akihito Ishida3
1Department of Pediatrics, International University of Health and Welfare Hospital, 537-3 Iguchi, Nasushiobara-shi, Tochigi 329-2763, Japan.
Insights
Right ventricular (RV) function in preterm infants changes with age and respiratory status, assessed via tissue Doppler imaging (TDI). RV TDI velocities offer insights into RV function in critically ill newborns.
Area of Science:
- Neonatal Cardiology
- Pediatric Echocardiography
- Cardiovascular Physiology
Background:
- Assessing right ventricular (RV) function is crucial in preterm infants.
- Tissue Doppler imaging (TDI) echocardiography offers a method for longitudinal RV function evaluation.
Purpose of the Study:
- To longitudinally evaluate right ventricular (RV) function in preterm infants using tissue Doppler imaging (TDI).
Main Methods:
- 101 very-low-birth-weight (VLBW) infants underwent serial echocardiographic examinations including TDI.
- Pulsed-Doppler TDI waveforms at the tricuspid valve annulus measured peak systolic (Sa), early diastolic (Ea), and late diastolic (Aa) velocities.
Main Results:
- RV TDI velocities (Sa, Ea, Aa) showed significant changes within the first 12 hours, then increased gradually.
- Velocities correlated with gestational age and postnatal age; Sa associated with cardiac output.
- Intubated infants had higher Sa and Aa velocities compared to non-intubated infants.
Conclusions:
- RV TDI velocities in preterm infants are influenced by gestational age, postnatal age, and respiratory status.
- The RV E/Ea ratio remained stable, suggesting its utility in assessing RV function.
- Findings support RV TDI as a basis for assessing RV function in critically ill preterm infants.
Background:
We aimed to evaluate right ventricular (RV) function longitudinally using tissue Doppler imaging (TDI) echocardiography in preterm infants.
Methods:
We selected 101 very-low-birth-weight (VLBW) infants for the study. Echocardiographic examinations including TDI were performed serially within 7days of life. Pulsed-Doppler TDI waveforms were recorded at the tricuspid valve annulus, and peak systolic velocities (Sa), early diastolic velocities (Ea), and late diastolic velocities (Aa) were measured.
Results:
Sa, Ea and Aa were all reduced significantly from 3h to 12h, and then increased gradually thereafter. These three velocities also increased with gestational age in the early neonatal period. The ratio of Ea to Aa (Ea/Aa) did not change significantly within the first week of life. The ratio of E to Ea (E/Ea) in VLBW infants also seemed to remain stable from birth to day 7. The values of Sa appeared to be associated with cardiac output in the early neonatal period. Both Sa and Aa in intubated infants were significantly higher than in non-intubated infants.
Conclusion:
RV TDI velocities of preterm infants in the early neonatal period are influenced by gestational age, postnatal age, and respiratory status, although the RV E/Ea ratio appears to be almost stable throughout the neonatal period. Our findings may provide some basis for assessment of RV function in critically ill preterm infants.
