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Early Postnatal Ventricular Dysfunction Is Associated with Disease Severity in Patients with Congenital Diaphragmatic

Neil Patel1, Anna Claudia Massolo2, Anshuman Paria1

  • 1Department of Neonatology, Royal Hospital for Children, Glasgow, United Kingdom.

The Journal of Pediatrics
|September 10, 2018
PubMed

Insights

Infants with congenital diaphragmatic hernia (CDH) show impaired heart function, especially in the left ventricle (LV). Early LV function predicts disease severity and outcomes, suggesting targeted cardiac therapies for CDH.

Area of Science:

  • Pediatric Cardiology
  • Neonatal Physiology
  • Congenital Anomalies Research

Background:

  • Congenital diaphragmatic hernia (CDH) significantly impacts neonatal cardiorespiratory function.
  • Understanding the transitional cardiac physiology in CDH is crucial for predicting outcomes.
  • Postnatal ventricular dysfunction is a recognized complication in CDH infants.

Purpose of the Study:

  • To evaluate postnatal ventricular function patterns in infants with CDH.
  • To correlate cardiac function with prenatal and postnatal indicators of disease severity.
  • To identify potential therapeutic targets for cardiovascular management in CDH.

Main Methods:

  • Observational case-control study involving infants with CDH and healthy controls.
  • Speckle tracking echocardiography and tissue Doppler imaging assessed RV and LV systolic/diastolic function.
  • Correlations were analyzed between cardiac function and markers like TFLV, OI, intubation duration, and hospital stay.

Main Results:

  • Infants with CDH exhibited reduced RV and LV systolic and diastolic function compared to controls within the first 48 hours of life.
  • LV global systolic longitudinal strain (GLS) in CDH infants correlated significantly with TFLV, OI, intubation duration, and length of stay.
  • Lower LV GLS in the first 48 hours was associated with poorer survival and increased need for ECMO in CDH infants.

Conclusions:

  • Ventricular function is impaired during the transitional period in infants with CDH.
  • Early LV systolic function serves as a significant predictor of clinical disease severity in CDH.
  • Regular cardiac function assessment and targeted cardiovascular therapies are recommended for CDH management.
Abstract

Keywords:
diastolicleft ventriclepulmonary hypertensionright ventriclesystolic

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