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Left ventricular diastolic function during the first month of life
J C Fouron1, F Heitz, A M Carceller
1Department of Pediatrics, Hopital Sainte-Justine, Canada.
Insights
Left ventricle diastolic function in infants shows greater variation in the first day of life but improves significantly by one month. These changes are crucial for newborns with cardiopulmonary disease.
Area of Science:
- Cardiology
- Neonatal Physiology
- Pediatric Echocardiography
Background:
- Myocardial relaxation is crucial for cardiac function.
- Understanding diastolic function changes in neonates is vital for managing cardiopulmonary conditions.
Purpose of the Study:
- To assess changes in myocardial relaxation and left ventricle diastolic function during the neonatal period.
- To evaluate the progression of diastolic function from the first day to one month of age in healthy infants.
Main Methods:
- Serial M-mode echocardiograms were performed on 9 normal term infants and 10 one-month-old infants.
- Echocardiographic tracings were analyzed using an M-mode calculator to assess diastolic function indices.
Main Results:
- No significant differences in left ventricle diastolic function indices were found within the first 4 days of age, despite greater individual variations.
- Significant increases in left ventricle compliance were observed between 4 days and 1 month of age, indicated by changes in peak filling rate, aortic root motion, posterior wall motion, mitral valve EF slope, and relaxation time.
Conclusions:
- Left ventricle diastolic function exhibits greater variability in the first day of life.
- A significant increase in left ventricle compliance occurs within the first month of life.
- These developmental changes in diastolic function are critical for the clinical outcomes of newborns with cardiopulmonary disease.
Unlabelled:
In order to assess possible changes in myocardial relaxation occurring during the neonatal period, M-mode echocardiograms were recorded serially in 9 normal term infants and in another group of 10 one-month-old infants. The tracings were studied with an M-mode calculator. Although individual variations were greater in the data collected during the first 24 h, no significant difference was found in the indices of diastolic function of the left ventricle during the first 4 days of age. The following changes were observed between data recorded at 4 days and 1 month, respectively: normalized peak rate of left ventricle filling, 4.03 vs. 4.71 cm/s; diastolic peak velocity of early posterior motion of aortic root, 1.89 vs. 5.15 cm/s; peak velocity of left ventricle posterior wall motion in diastole, 3.31 vs. 3.50 cm/s; mitral valve EF slope, 59.05 vs. 84.92 mm/s; left ventricle isometric relaxation time, 43.88 vs. 28.50 ms.
In Conclusion:
(1) greater individual variations are observed in indices of left ventricle diastolic function during the first day of life, and (2) significant increase in left ventricle compliance occurs during the first month of life. These changes should play a critical role in the clinical course of newborn with cardiopulmonary disease.