Left atrium function and deformation in very preterm infants with and without volume load

Area of Science:

• Pediatric Cardiology
• Neonatal Echocardiography
• Cardiac Mechanics

Background:

• Left atrial (LA) function is crucial for cardiac health and can be evaluated using various echocardiographic methods.
• Two-dimensional speckle tracking echocardiography (2DSTE) offers advanced assessment of LA volume and deformation, including reservoir, conduit, and contraction phases.
• Patent ductus arteriosus (PDA) frequently causes volume overload and left atrial dysfunction in very preterm infants.

Purpose of the Study:

• To determine the feasibility and reliability of LA 2DSTE in preterm infants.
• To describe LA function in preterm infants with and without the volume load of a PDA.

Main Methods:

• Prospective recruitment of preterm infants (<30 weeks gestation) with suspected PDA.
• Cardiac ultrasound performed at day 3 and week 4 of life.
• Analysis using conventional echocardiography and 2DSTE for LA function assessment.

Main Results:

• LA 2DSTE was feasible in 96% of measurements with good reliability for strain and volume parameters.
• Poorer LA contraction and reservoir function correlated with larger LA volume, higher mitral inflow, and elevated EA and Ee' ratios.
• Larger PDA diameter independently contributed to impaired LA contraction and reservoir function.

Conclusions:

• LA 2DSTE is a feasible technique providing detailed insights into left atrial mechanics in preterm infants.
• Further research is warranted to establish the clinical utility of these advanced echocardiographic parameters in neonates.