Longitudinal Strain vs. Conventional Echocardiographic Parameters in the First Week of Life in Healthy Term Newborns
Jerneja Rešek Peček1,2, Mirta Koželj3,2, Petja Fister4,5
1Department of Pediatric Critical Care, Children's Hospital, University Medical Centre Ljubljana, Bohoričeva 20, 1000, Ljubljana, Slovenia.
Insights
In healthy newborns, cardiac function significantly improves within the first week of life, with notable increases in myocardial strain and tissue Doppler velocities. These findings highlight sensitive echocardiographic markers for assessing neonatal hemodynamic adaptation.
Area of Science:
- Neonatal cardiology
- Pediatric cardiovascular physiology
- Echocardiographic imaging techniques
Background:
- The first week of life involves significant hemodynamic shifts in newborns.
- Myocardial contractility changes are expected to reflect these hemodynamic alterations.
- Understanding ventricular function during this transitional period is crucial for assessing infant health.
Purpose of the Study:
- To evaluate right and left ventricular function in healthy term newborns on the third and seventh days of life.
- To assess changes in myocardial contractility and compliance using various echocardiographic methods.
- To identify sensitive echocardiographic parameters reflecting hemodynamic adaptation in early neonatal life.
Main Methods:
- Speckle tracking echocardiography was employed to assess myocardial function.
- Pulsed-wave tissue Doppler imaging, M-mode, and Doppler techniques were utilized for ventricular function assessment.
- Fifty healthy term newborns were studied at two time points: day 3 and day 7 of life.
Main Results:
- A significant increase in both right and left ventricular longitudinal strain was observed.
- Systolic and diastolic tissue Doppler velocities showed a significant increase.
- Right ventricular parameters were generally greater than left, with similar temporal changes for both ventricles.
- Indirect signs of decreasing pulmonary and increasing systemic vascular resistance were noted.
Conclusions:
- Echocardiographic techniques effectively capture hemodynamic changes and alterations in myocardial contractility and compliance in neonates.
- Longitudinal strain and tissue Doppler imaging parameters demonstrate higher sensitivity than conventional echocardiographic measures.
- These findings provide valuable insights into neonatal cardiovascular adaptation using advanced echocardiography.
Abstract:
The first week of life is characterized by substantial alterations in hemodynamic conditions. Changes in myocardial contractility will reflect these changes. We aimed to assess right and left ventricular function on the third and seventh days of life in 50 healthy term newborns. To assess myocardial function, we used speckle tracking echocardiography. Pulsed-wave tissue Doppler imaging, M-mode, Doppler and pulsed-wave Doppler were also used to assess ventricular function. We found a significant increase in both right and left longitudinal strain and an increase in systolic and diastolic tissue Doppler velocities, whereas most other parameters remained unchanged. At both time points, the measured parameters were significantly greater for the right ventricle, but the changes with time were similar for both ventricles. We also found an increase in right ventricular outflow tract acceleration time as an indirect sign of decreasing pulmonary vascular resistance and an increase in systolic blood pressure, pointing to increasing systemic vascular resistance. Together with a decreasing proportion of patients with patent ductus arteriosus, the estimated left ventricular cardiac output decreased and right ventricular cardiac output increased but not to a statistically significant degree. In conclusion, the results of our study show how different echocardiographic techniques capture hemodynamic changes and changes in myocardial contractility and compliance. Both longitudinal strain and tissue Doppler imaging parameters seem to offer greater sensitivity in comparison with conventional echocardiographic parameters.
