Myocardial Strain in the Healthy Neonate
Kerstin Magnusson1, Katarina Övermo Tydén1,2, Felicia Nordenstam1,2
1Department of Pediatric Cardiology, Karolinska University Hospital, Stockholm, Sweden.
Insights
Two-dimensional speckle tracking echocardiography (2DSTE) strain analysis is feasible in neonates. Myocardial strain increased significantly by 3-4 weeks, indicating improved cardiac function after birth.
Area of Science:
- Cardiology
- Neonatal Medicine
- Medical Imaging
Background:
- Conventional echocardiography has limitations in assessing neonatal cardiac function.
- Two-dimensional speckle tracking echocardiography (2DSTE) derived strain can quantify systolic ventricular and atrial function.
- Early detection of cardiac function changes is crucial in neonates, but reference data is scarce.
Purpose of the Study:
- To describe myocardial strain in healthy neonates during the first day and at 3-4 weeks of age.
- To evaluate the feasibility of 2DSTE in this population.
- To establish reference values for neonatal myocardial strain.
Main Methods:
- A cohort of 24 full-term neonates underwent echocardiographic examination twice.
- Examinations were performed on the first day of life and at 3 weeks of age.
- A specific echocardiographic protocol was followed to assess cardiac function and strain.
Main Results:
- 2DSTE strain analysis was feasible in healthy neonates.
- Right ventricular free wall strain, left ventricular global longitudinal strain, and atrial reservoir and conduit strain increased significantly by 3-4 weeks (p < 0.001).
- Conventional right ventricular function measurements also showed improvement.
Conclusions:
- Strain analysis using 2DSTE is a feasible method for quantifying neonatal cardiac function.
- Increased myocardial strain at 3-4 weeks suggests improved systolic and diastolic function during circulatory adaptation.
- This study provides valuable data on myocardial strain in healthy neonates.
Aim:
Conventional echocardiographic measurements of cardiac function in neonates have several limitations. Deformation imaging like 2D speckle tracking echocardiography (2DSTE) derived strain can contribute to quantifying systolic ventricular and atrial function. Strain is known to detect early changes in cardiac function. While reference values for the paediatric population are available, data for neonates < 30 days of age are scarce. This study aimed to describe myocardial strain in healthy neonates during their first day of life and at 3-4 weeks of age, and to evaluate the feasibility of 2DSTE in this population.
Methods:
Full-term neonates (n = 24) were examined twice: on their first day and at 3 weeks of age, according to a designed echocardiographic protocol.
Results:
Right ventricular free wall strain, left ventricular global longitudinal strain, and right- and left atrial reservoir and conduit strain were all increased (p < 0.001) at the second examination. Conventional measurements of right ventricular function were also higher (p < 0.001) at the second examination.
Conclusion:
Strain analysis is feasible in healthy neonates and contributes to quantifying atrial and ventricular function. The increased myocardial strain at 3-4 weeks of age indicates systolic and diastolic improvement during circulatory adaptation after birth.
