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Updated: Mar 31, 2026
Author Spotlight: Advancing Neonatal Cardiac Diagnostics with Echocardiography-Derived Blood Speckle Imaging
Published on: December 22, 2023
Cardiac Function After the Immediate Transitional Period in Very Preterm Infants Using Speckle Tracking Analysis
Koert de Waal1,2, Nilkant Phad3,4, Anil Lakkundi3,4
1Neonatal Intensive Care Unit, John Hunter Children's Hospital, Lookout Road, New Lambton, NSW, 3205, Australia. koert.dewaal@hnehealth.nsw.gov.au.
Insights
Speckle tracking echocardiography (STE) reliably measures preterm infant cardiac function. Despite patent ductus arteriosus (PDA), preterm hearts maintain function well in the early weeks post-birth.
Area of Science:
- Neonatal Physiology
- Cardiovascular Medicine
- Medical Imaging
Background:
- The postnatal period presents significant physiological changes in preterm infants.
- Monitoring cardiovascular function is crucial for timely intervention and treatment.
- Novel imaging techniques are needed to assess cardiac function in this vulnerable population.
Purpose of the Study:
- To evaluate the feasibility and reliability of speckle tracking echocardiography (STE) for assessing cardiac function in preterm infants.
- To compare STE-derived cardiac parameters with conventional echocardiographic measures.
- To analyze changes in cardiac function over the first four weeks of postnatal life in preterm infants.
Main Methods:
- Cardiac ultrasound images were acquired at days 3, 7, 14, 21, and 28 in preterm infants (<30 weeks gestation).
- Conventional echocardiographic measures included cardiac size, stroke volume, atrial volume, and patent ductus arteriosus (PDA).
- Four-chamber images were analyzed using STE to derive left ventricular volume, longitudinal deformation, and myocardial velocities.
Main Results:
- STE demonstrated good reliability for most cardiac parameters.
- STE-derived stroke volume showed good correlation but suboptimal agreement with conventional methods.
- Volume parameters and systolic/atrial velocities increased over time; cardiac deformation and early diastolic velocity remained unchanged.
- A PDA was associated with increased stroke volume, a spherically enlarged heart, and elevated filling pressures.
Conclusions:
- Speckle tracking echocardiography is a feasible and reliable method for assessing systolic and diastolic function, deformation, and velocities in preterm infants.
- Preterm hearts demonstrate robust cardiac function maintenance in the initial weeks post-birth.
- The technique provides comprehensive cardiac assessment from a single ultrasound window, even in the presence of a PDA.
Background:
The postnatal period in preterm infants involves multiple physiologic changes starting directly after birth and continuing for days or weeks. To recognize and treat compromise, it is important to measure cardiovascular function. We used a novel technique (speckle tracking echocardiography, STE) to measure cardiac function in this period.
Methods:
We obtained cardiac ultrasound images at day 3, 7, 14, 21 and 28 in preterm infants <30-week gestation. Conventional measures included cardiac size, left ventricular stroke volume, atrial volume and the patent ductus arteriosus (PDA). Four chamber images were analyzed with STE, which provided parameters of left ventricular volume, longitudinal deformation and myocardial velocities.
Results:
Images of 54 infants (gestational age 23-29 weeks) were analyzed. STE-derived stroke volume correlated well with conventional echocardiography-derived stroke volume, but agreement was suboptimal. Most STE parameters showed good reliability. All volume parameters and systolic and atrial velocities increased over time. Cardiac deformation and early diastolic velocity did not change. A PDA was associated with 33 % increased stroke volume at day 3 up to 98 % at day 28 with a spherically enlarged heart and increased filling pressure.
Conclusion:
Speckle tracking echocardiography analysis is a feasible and reliable technique that can simultaneously obtain systolic and diastolic volumes, longitudinal deformation and myocardial velocities from one ultrasound window. Preterm hearts maintain cardiac function well during the first weeks of life, even with increased preload as a consequence of a PDA.
