Maturational patterns of left ventricular rotational mechanics in pre-term infants through 1 year of age

Area of Science:

• Cardiology
• Neonatology
• Pediatric Cardiovascular Research

Background:

• Premature birth poses long-term cardiovascular risks due to impaired left ventricular development.
• Understanding the maturation of cardiac rotational properties in preterm infants is crucial for assessing future cardiovascular health.

Purpose of the Study:

• To investigate maturational changes in left ventricular rotational properties from birth to 1 year in preterm infants.
• To determine the impact of bronchopulmonary dysplasia, pulmonary hypertension, and patent ductus arteriosus on these measures.

Main Methods:

• Prospective enrollment of 117 preterm infants (<29 weeks gestation) followed to 1-year corrected age.
• Two-dimensional speckle-tracking echocardiography used to measure left ventricular basal and apical rotation, twist, and torsion at 32 and 36 weeks postmenstrual age and 1-year corrected age.
• Mixed random effects model with repeated measures analysis compared rotational mechanics over time; torsion compared between infants with and without cardiopulmonary complications.

Main Results:

• Left ventricular torsion significantly decreased from 32 weeks postmenstrual age to 1-year corrected age in all preterm infants (p < 0.001).
• The decline in torsion was more pronounced between 32 and 36 weeks postmenstrual age in infants with cardiopulmonary complications.
• Rotational mechanics normalized between 36 weeks postmenstrual age and 1-year corrected age, with similar declines observed in both groups.

Conclusions:

• Left ventricular torsion naturally declines from the neonatal period through the first year of life in preterm infants.
• Cardiopulmonary diseases of prematurity may transiently impair neonatal rotational mechanics, but myocardial function recovers by 1-year corrected age.