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Risk factors and prognostic significance of altered left ventricular geometry in preterm infants

Swati Choudhry1, Amber Salter2, Tyler W Cunningham1

  • 1Department of Pediatrics, Washington University School of Medicine, Saint Louis, MO, USA.

Journal of Perinatology : Official Journal of the California Perinatal Association
|February 8, 2018
PubMed

Insights

Altered left ventricular (LV) geometry in preterm infants is linked to postnatal steroid use and being small for gestational age. Elevated relative wall thickness (RWT) indicates longer hospital stays and higher mortality risk.

Area of Science:

  • Neonatal Cardiology
  • Pediatric Cardiovascular Research
  • Infant Cardiac Health

Background:

  • Left ventricular (LV) hypertrophy (LVH) is a known predictor of adverse cardiac events in adults.
  • The risk factors and prognostic significance of altered LV geometry in preterm infants remain under-investigated.

Purpose of the Study:

  • To determine the risk factors associated with altered LV geometry in preterm infants.
  • To evaluate the prognostic significance of altered LV geometry in this population.

Main Methods:

  • Retrospective, single-center, case-control study.
  • Echocardiographic analysis of 503 preterm infants (≤2 kg).
  • Assessment of left ventricular mass index (LVMI) and relative wall thickness (RWT) for altered LV geometry.

Main Results:

  • Altered LV geometry was identified in 180 infants, predicted by postnatal steroid use and being small for gestational age.
  • Elevated RWT correlated with longer hospital stays.
  • Fifteen of 94 infants with elevated RWT died, compared to 3 of 90 controls (P=0.004).

Conclusions:

  • Altered LV geometry in preterm infants is associated with postnatal steroid administration and being small for gestational age.
  • Elevated RWT in preterm infants is linked to increased mortality and prolonged hospitalization.
Abstract

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