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Author Spotlight: Advancing Neonatal Cardiac Diagnostics with Echocardiography-Derived Blood Speckle Imaging
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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.
Pediatric Cardiology
|October 17, 2015
Summary
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.
