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Patent ductus arteriosus status and treatment response alters myocardial adaptation in preterm infants

Rachel Mullaly1, Aisling Smith1, Orla Franklin2

  • 1Department of Neonatology, The Rotunda Hospitalhttps://ror.org/05t4vgv93, Dublin, Ireland.

Cardiology in the Young
|January 26, 2026
PubMed

Insights

Patent ductus arteriosus (PDA) treatment success in preterm infants improves heart function. Treatment failure leads to lasting heart and blood flow changes, emphasizing early closure benefits.

Area of Science:

  • Neonatal cardiology
  • Pediatric cardiac imaging
  • Perinatal medicine

Background:

  • Patent ductus arteriosus (PDA) significantly impacts myocardial adaptation in preterm infants.
  • Understanding PDA treatment response is crucial for managing cardiac outcomes in vulnerable neonates.
  • Serial echocardiography provides insights into evolving cardiac function and structure.

Purpose of the Study:

  • To compare serial echocardiographic trajectories of myocardial adaptation in preterm infants based on PDA status and treatment response.
  • To investigate the long-term effects of PDA treatment success versus failure on cardiac structure and function.
  • To differentiate cardiac adaptation patterns between high-risk (treated) and low-risk (untreated) preterm infants.

Main Methods:

  • Prospective cohort study of preterm infants (< 29 weeks' gestation) stratified by EL-Khuffash PDA Severity Score and treatment response.
  • Serial echocardiographic assessments at day 2, 2 weeks, and 36 weeks corrected gestational age.
  • Analysis of structural and functional cardiac parameters, including left ventricular wall thickness and strain metrics.

Main Results:

  • Infants with treatment failure showed persistent myocardial and hemodynamic alterations, including increased left ventricular wall thickness.
  • Treatment success correlated with improved strain metrics, systemic perfusion, and structural indices.
  • Distinct early changes in myocardial trajectories were observed between groups from day 2 to 2 weeks.

Conclusions:

  • PDA treatment response dynamically impacts myocardial adaptation in preterm infants.
  • Persistent PDA despite treatment is linked to sustained adverse structural and functional cardiac changes.
  • Early, definitive PDA closure may enhance hemodynamic stability and prevent maladaptive cardiac remodeling.
Abstract

Keywords:
cardiac remodellingneonatal haemodynamicspatent ductus arteriosustargeted neonatologist-performed echocardiography

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