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Reference Values for Point-of-Care Echocardiographic Measurements of Preterm Infants in China
Dan-Fang Lu1, Xiao-Mei Tong1, Yun-Feng Liu1
1Department of Pediatrics, Peking University Third Hospital, Beijing, China.
Insights
This study establishes point-of-care echocardiographic reference ranges for preterm infants, providing crucial data on left ventricular structure and function. These findings aid in identifying potential echocardiographic abnormalities in neonates.
Area of Science:
- Neonatal cardiology
- Pediatric echocardiography
- Cardiovascular physiology in neonates
Background:
- Limited reference values exist for left ventricular structure and function in preterm infants.
- Establishing point-of-care echocardiographic norms is essential for this vulnerable population.
- This study addresses the need for reliable reference ranges in preterm neonates within the first week of life.
Purpose of the Study:
- To establish point-of-care echocardiographic reference ranges for left ventricular structure and function in preterm infants.
- To correlate these measurements with gestational age, birth weight, and body surface area (BSA).
- To provide normative data for identifying potential echocardiographic abnormalities.
Main Methods:
- Retrospective analysis of echocardiographic data from 489 preterm infants.
- Inclusion of M-mode and pulsed wave Doppler measurements of left ventricular dimensions and flow velocities.
- Development of percentile curves using Generalized Additive Models for Location, Scale and Shape (GAMLSS) in R.
Main Results:
- Cardiac dimensions and Doppler velocities showed significant correlations with gestational age, weight, and BSA.
- Left ventricular end-diastolic dimensions (LVED), left atrial diameter (LAD), and mitral valve E wave (MV-E) demonstrated increasing trends with gestational age and weight.
- Percentile curves were generated for key echocardiographic parameters.
Conclusions:
- The study provides reliable percentile tables and graphs for point-of-care echocardiographic data in Chinese neonates.
- These normative values serve as a critical reference for identifying potentially abnormal echocardiograms.
- This data supports improved clinical assessment and management of preterm infants.
Background:
Few studies have examined the reference value of the left ventricular structure and function in preterm infants. This study was designed to establish a point-of-care echocardiographic reference range of left ventricular structure and function based on different gestational age, weight, and body surface area (BSA) for preterm infants within 7 days after birth.
Methods:
We retrospectively studied 489 patients with traditional echocardiographic data of left ventricular (LV) M-mode: LV end diastolic dimensions (LVED), LV end systolic dimension (LVES), end-diastolic interventricular septal thickness (IVSd), end diastolic LV posterior wall thickness (LVPWd), left atrial (LA) and aortic root (AO) diameters, and index of LA/AO, LV ejection fraction (LVEF), LV fractional shortening (LVFS), and pulsed wave Doppler: aortic valve flow rate (AV), peak mitral valve flow rate E(MV-E), peak mitral valve flow rate A(MV-A), and MV-E/A. The LV dimensions and the maximum blood flow velocities of the aortic valves and mitral valves according to gestational age, birth weight, and body surface area (BSA) are presented in percentiles tables. Percentile curves of aforesaid four cardiac measurements (LVED, LA diameter (LAD), MV-E, MV-E/A) using the R language Generalized Additive Models for Location, Scale and Shape (GAMLSS) method were developed according to different gestational ages and weights.
Results:
Measurements of all cardiac dimensions and Doppler maximum velocities of AV, MV-E, and MV-E/A showed a correlation with gestational age, weight, and BSA. LVED, LAD, MV-E, and MV-E/A showed a trend of increasing values with gestational age and weight on the percentile curves.
Conclusion:
The percentile tables and graphs of these point-of-care echocardiographic data can provide reliable reference data for Chinese neonates. Normative values are recommended as a source of reference data for the identification of potentially abnormal echocardiography.
