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Cardiac adaptations to patent ductus arteriosus ligation in preterm infants: a speckle-tracking study

Katsuaki Toyoshima1, Hirosato Aoki2, Takahiro Noguchi2

  • 1Department of Neonatology, Kanagawa Children's Medical Center, Yokohama, Japan. nqf37179@nifty.com.

Pediatric Research
|July 19, 2025
PubMed

Insights

Cardiac function in preterm infants after patent ductus arteriosus (PDA) ligation shows distinct adaptations. Left ventricular and left atrial strain initially decrease then recover, while right ventricular strain normalizes post-surgery.

Area of Science:

  • Cardiology
  • Neonatology
  • Pediatric Surgery

Background:

  • Patent ductus arteriosus (PDA) ligation is a common procedure in preterm infants.
  • Understanding cardiac adaptations post-PDA ligation is crucial for optimizing care.
  • Preterm infants with PDA exhibit altered cardiac mechanics preoperatively.

Purpose of the Study:

  • To test the hypothesis that left ventricular (LV), left atrial (LA), and right ventricular (RV) longitudinal strain are acutely impaired and recover after PDA surgery in preterm infants.
  • To investigate the dynamic changes in cardiac strain following PDA ligation.
  • To compare cardiac strain parameters between preterm infants with and without PDA.

Main Methods:

  • Speckle-tracking echocardiography was used to quantify LV, LA, and RV longitudinal strain.
  • Measurements were taken preoperatively and at 4-8 and 24-48 hours post-PDA ligation.
  • A control group of 36 preterm infants without PDA was included for comparison.

Main Results:

  • Preoperatively, PDA group had higher LV global longitudinal strain (LVGLS) and lower RV free wall strain (RVFWSL) than non-PDA group.
  • Post-ligation, LVGLS and LA reservoir strain (LASr) transiently decreased then recovered within 24-48 hours.
  • RVFWSL rapidly improved post-ligation, normalizing without a significant decrease.

Conclusions:

  • LVGLS and LASr show transient impairment followed by recovery after PDA ligation.
  • RVFWSL normalizes quickly post-PDA ligation, indicating differential adaptation between ventricles.
  • Findings highlight dynamic and distinct right and left ventricular cardiac adaptations post-PDA surgery.
Abstract

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