Right Ventricular Function in Neonates During Early Postnatal Period: A Prospective Observational Study

Area of Science:

• Neonatal cardiology
• Pediatric echocardiography
• Cardiovascular physiology

Background:

• Limited data exists on right ventricular (RV) function changes in term newborns after the initial 72 hours of life.
• Previous echocardiographic studies primarily focused on preterm infants and the early fetal-to-neonatal transition.

Purpose of the Study:

• To quantitatively assess changes in RV function using echocardiography in healthy term newborns.
• To investigate RV function, output, and afterload between the third and seventh days of life.

Main Methods:

• Prospective observational study involving 35 healthy term newborns.
• Echocardiographic examinations performed on the third and seventh days of life.
• Assessment of RV function parameters including tissue Doppler imaging (TDI), RV longitudinal strain, and RV outflow tract parameters.

Main Results:

• Significant increases observed in RV systolic and diastolic myocardial velocities and RV longitudinal strain.
• Higher mean RV outflow tract velocity time integral and a lower myocardial performance index (MPI') were noted.
• Tricuspid annular plane systolic excursion and RV filling patterns showed no significant changes.

Conclusions:

• Findings suggest a reduction in RV afterload and adaptive myocardial maturation in term newborns between day 3 and day 7.
• Advanced echocardiographic techniques like pulsed-wave TDI and 2D speckle-tracking are more sensitive for evaluating RV function compared to traditional methods.