Normative Echocardiographic Values for Right and Left Ventricular Function in Extremely Premature Neonates

Area of Science:

• Neonatal Cardiology
• Pediatric Echocardiography
• Perinatology

Background:

• Extremely premature neonates (<29 weeks) present unique physiological challenges.
• Understanding biventricular function and pulmonary vascular resistance (PVR) is crucial for managing these infants.
• Maturation of myocardial performance in this population requires further investigation.

Purpose of the Study:

• To establish normative values for biventricular function and PVR surrogates in stable, extremely premature neonates.
• To assess maturational changes in myocardial performance from birth to term-corrected age.
• To compare cardiac function in extremely premature neonates with healthy term infants.

Main Methods:

• Prospective observational study of clinically stable extremely preterm newborns (<29 weeks GA).
• Infants divided into three gestational age cohorts (24-29 weeks).
• Serial echocardiograms performed on days 3-5, 7-10, and prior to discharge.

Main Results:

• 46 stable extremely preterm neonates were included.
• Echocardiography reliably assessed myocardial performance with high inter-reader correlation.
• Normative values for right and left ventricular function and PVR surrogates were identified.

Conclusions:

• Biventricular systolic performance in stable extremely premature neonates differs significantly from term infants.
• All preterm neonates exhibited poor biventricular compliance at birth, which improved with maturation.
• Extreme prematurity did not negatively impact myocardial functional maturation by term-corrected age.