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Ventricular Dysfunction, Interdependence, and Mechanical Dispersion in Newborn Infants with Congenital Diaphragmatic

Anna Claudia Massolo1, Anshuman Paria2, Lindsey Hunter3

  • 1Department of Medical and Surgical Neonatology, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy, annaclaudia.massolo@opbg.net.

Neonatology
|May 16, 2019
PubMed

Insights

Congenital diaphragmatic hernia (CDH) impairs heart function in newborns, showing reduced ventricular mechanics and synchrony. This study highlights global cardiac dysfunction in infants with CDH.

Area of Science:

  • Neonatal cardiology
  • Pediatric cardiac imaging
  • Congenital heart defects

Background:

  • Congenital diaphragmatic hernia (CDH) is a critical neonatal condition.
  • Pulmonary hypertension and hypoplasia are primary issues in CDH.
  • Cardiac function is increasingly recognized as vital in CDH severity and outcomes.

Purpose of the Study:

  • To evaluate ventricular mechanics and synchrony in infants with CDH.
  • To compare cardiac function in CDH infants versus healthy controls.
  • To utilize speckle tracking echocardiography (STE) for detailed cardiac assessment.

Main Methods:

  • Retrospective analysis of echocardiograms from 27 CDH infants and 20 controls within 48 hours of birth.
  • Speckle tracking echocardiography (STE) used to measure longitudinal strain (LS) in both ventricles (RV, LV).
  • LV circumferential (CS) and radial strain (RS) measured; mechanical dispersion (MD) assessed for synchrony.

Main Results:

  • Significantly reduced RV LS, LV LS, LV CS, and LV RS in CDH infants compared to controls.
  • LV free wall LS and RS were notably diminished in the CDH group.
  • LV LS correlated with RV LS and LV mechanical dispersion in CDH infants.

Conclusions:

  • Newborns with CDH exhibit global impairment of right and left ventricular systolic function.
  • These impairments are linked to left ventricular dysfunction, ventricular interdependence, and mechanical dispersion.
  • Cardiac mechanics and synchrony are crucial factors in CDH.
Abstract

Keywords:
Congenital diaphragmatic herniaInterdependenceMechanical dispersionMyocardial strainPulmonary hypertension

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