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Assessment of Right Ventricular Structure and Function in Mouse Model of Pulmonary Artery Constriction by Transthoracic Echocardiography
Published on: February 3, 2014
Right ventricular function indices and platelet parameters for early prediction value of bronchopulmonary dysplasia:
Tianzi Li1, Bei Xia1, Suixin Liang2
1Department of Ultrasound, Shenzhen Children's Hospital of China Medical University, Shenzhen, Guangdong, China.
Insights
Early echocardiographic indices and platelet parameters can identify preterm infants at high risk for bronchopulmonary dysplasia (BPD). Tricuspid annular plane systolic excursion (TAPSE) and right ventricular index of myocardial performance (RIMP), combined with platelet count and mean platelet volume (MPV), improve BPD prediction.
Area of Science:
- Neonatal Medicine
- Pediatric Cardiology
- Critical Care
Background:
- Bronchopulmonary dysplasia (BPD) is a significant complication in preterm infants.
- Early identification of infants at risk for BPD is crucial for timely intervention.
- Right ventricular function and platelet parameters are potential early indicators.
Purpose of the Study:
- To evaluate the predictive value of early echocardiographic indices of right ventricular function combined with platelet (PLT) parameters for BPD in preterm infants.
- To identify independent risk factors for BPD development.
Main Methods:
- Retrospective study of preterm infants (GA < 32 weeks) admitted to the NICU.
- Echocardiographic assessment of right ventricular function (TAPSE, RIMP) on DOL 1, 7, and 14.
- Measurement of PLT parameters (PLT count, MPV, PCT, PDW) on DOL 1, 7, and 14.
- Multivariate logistic regression and ROC curve analysis to determine predictive value.
Main Results:
- Infants who developed BPD showed higher RIMP and lower TAPSE on DOL 14 compared to non-BPD infants.
- BPD infants had lower PLT count and higher MPV on DOL 1.
- Gestational age, mechanical ventilation duration, PLT count, MPV, TAPSE, and RIMP were independent risk factors for BPD.
- Combined use of right ventricular function indices and PLT parameters improved BPD prediction (AUC = 0.846).
Conclusions:
- Tricuspid annular plane systolic excursion (TAPSE) and right ventricular index of myocardial performance (RIMP) are valuable early echocardiographic markers for BPD risk.
- Platelet count and mean platelet volume (MPV) also contribute to early BPD risk assessment.
- Combining TAPSE, RIMP, PLT count, and MPV enhances the identification of preterm infants at increased risk for developing BPD.
Background:
To examine the value of early echocardiographic indices for the right ventricular function combined with platelet(PLT) parameters for predicting bronchopulmonary dysplasia (BPD) in preterm infants.
Methods:
This retrospective study included infants with gestational age (GA) below 32 weeks, who were admitted to the neonatal intensive care unit(NICU). The detection rate of tricuspid regurgitation jet velocity (TRVJ), ventricular septal flattening, pulmonary artery widening, right ventricular dilation, and right atrial enlargement on the 7th day of life (DOL 7) were compared between BPD and non-BPD infants. Echocardiographic indices of the right ventricular function including tricuspid annular plane systolic excursion (TAPSE) and right ventricular index of myocardial performance (RIMP) were measured on 1 day of life (DOL 1)、on DOL 7 and on 14 day of life (DOL 14) respectively. The PLT parameters including the PLT count, mean platelet volume (MPV), platelet hematocrit (PCT) level, and platelet distribution width (PDW) were measured on the DOL 1,DOL 7, and DOL 14. Multivariate logistic regression was used to analyze the relationship between these parameters and BPD. Receiver operating characteristic curve analysis was performed to assess the predictive value of the right ventricular function indices and PLT parameters for BPD.
Results:
A total of 220 preterm infants were included in this study, and of these, 85 infants developed BPD among them. The RIMP of the BPD group on DOL 14 was higher than that of the non-BPD group (P < 0.05). The TAPSE of the BPD group on DOL 14 was lower than that of the non-BPD group (P < 0.05). The PLT count of the BPD group on DOL 1 was lower than that of the non-BPD group (P < 0.05), and the MPV of the BPD group on DOL 1 was higher than that of the non-BPD group (P < 0.05). Using multivariate logistic regression, GA、invasive mechanical ventilation duration ≥ 7 days、 PLT、 MPV、 TAPSE and RIMP were found to be independent risk factors for BPD. The area under the receiver operating characteristic curve was 0.846 (95CI: 0.794∼0.899), which improved when using right ventricular function indices combined with platelet parameters.
Conclusion:
TAPSE and RIMP combined with PLT count and MPV can help identify preterm infants at an increased risk of developing BPD.
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