Altered biventricular function in neonatal hypoxic-ischaemic encephalopathy: a case-control echocardiographic study

Area of Science:

• Neonatal Cardiology
• Pediatric Cardiology
• Cardiovascular Physiology

Background:

• Altered cardiac function in newborns with hypoxic-ischaemic encephalopathy (HIE) is linked to mortality and brain injury.
• Persistent pulmonary hypertension and myocardial ischemia are suspected mechanisms of cardiac dysfunction in HIE.
• Echocardiography is crucial for assessing cardiac function in neonates.

Purpose of the Study:

• To compare cardiac function in newborns with HIE to healthy controls.
• To utilize conventional and speckle-tracking echocardiography to evaluate biventricular function in HIE.
• To identify specific echocardiographic markers of cardiac dysfunction in HIE.

Main Methods:

• Retrospective case-control study (2008-2017) of neonates with moderate to severe HIE.
• Inclusion of 55 HIE newborns and 28 control subjects.
• Analysis of conventional and speckle-tracking echocardiography parameters for systolic and diastolic function.

Main Results:

• HIE newborns showed higher pulmonary pressures (systolic pulmonary pressure, SPP/SBP ratio).
• Significant alterations in right ventricular function (TAPSE, RV-MPI) and diastolic function (E/e') were observed in HIE.
• Left ventricular function showed subtle changes (e' velocity, LV-MPI), with significant deformation abnormalities (RV-LS, LV-LS) in HIE.

Conclusions:

• Newborns with HIE demonstrate increased pulmonary pressures.
• Altered biventricular systolic and diastolic function is evident in HIE neonates.
• Speckle-tracking echocardiography highlights significant myocardial deformation changes in HIE.