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Related Experiment Videos

Left ventricular mechanics in the normal newborn.

A J Rein1, S P Sanders, S D Colan

  • 1Department of Cardiology, Children's Hospital, Boston, MA 02115.

Circulation
|November 1, 1987
PubMed
Summary

Neonatal circulatory changes cause temporary left ventricular distortion, affecting heart function measurements. Standard echocardiography is unreliable in newborns until day 5 due to altered septal wall motion.

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Area of Science:

  • Neonatal physiology
  • Cardiovascular adaptation
  • Pediatric cardiology

Background:

  • The transition from fetal to neonatal circulation involves significant pressure changes in the heart ventricles.
  • These circulatory alterations can impact left ventricular performance, both globally and regionally.

Purpose of the Study:

  • To assess changes in left ventricular (LV) configuration and wall motion in normal newborns during the first five days of life.
  • To determine the reliability of standard echocardiographic measures of LV function in the neonatal period.

Main Methods:

  • Sequential two-dimensional echocardiography was performed on normal newborns.
  • Left ventricular global and regional wall motion were quantified using computer digitization with automated edge detection and a floating-center-of-mass model.

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  • Data were compared to a control group of infants and young children.

    • Main Results:

    • Newborns exhibited a circular LV end-diastolic shape from day 1.
    • Significant LV distortion, characterized by septal flattening, occurred at end-systole, persisting until day 3 and resolving by day 5.
    • Regional wall motion analysis showed augmented septal and free wall systolic movement in early neonatal life, normalizing by day 4.
    • Standard single-dimension shortening fraction was unreliable for assessing global LV performance before day 4.

    Conclusions:

    • Systolic right ventricular hypertension in neonates distorts LV configuration and alters regional wall motion for the first 4-5 days of life.
    • Conventional M-mode echocardiographic assessment of LV function is unreliable in newborns during this transitional period.