Related Experiment Video
Updated: Aug 6, 2026
Assessing Intracardiac Vortices with High Frame-Rate Echocardiography-Derived Blood Speckle Imaging in Newborns
Published on: December 22, 2023
Postnatal evolution of left ventricular rotational mechanics does not differ in extremely preterm infants with
Niki Oikonomopoulou1,2, Maria Jose Rodriguez1,2, Araceli Corredera1,2
1Department of Neonatology. Hospital Clínico San Carlos, Madrid, Spain.
Insights
Left ventricular rotational mechanics mature rapidly in preterm infants but do not predict adverse outcomes. Right ventricular function appears more critical for early brain injury in extremely preterm infants.
Area of Science:
- Neonatal cardiology
- Pediatric cardiology
- Cardiac mechanics
Background:
- Brain injury in extremely preterm infants is often linked to right ventricular dysfunction.
- The role of left ventricular rotational mechanics (LVRM) in this context is not well understood.
Purpose of the Study:
- To investigate the early postnatal development of LVRM in extremely preterm infants.
- To compare LVRM between infants with and without adverse short-term outcomes.
Main Methods:
- A prospective observational cohort study involving 63 extremely preterm infants.
- Echocardiography with speckle-tracking to assess LV strain, displacement, rotation, twist, and torsion at multiple time points within the first week.
- Adverse outcome defined as death and/or neurological injury (IVH, white matter injury).
Main Results:
- LVRM parameters, including strain, radial displacement, basal rotation, twist, and torsion, showed significant maturation within the first postnatal week.
- No significant differences in LVRM were observed between infants with and without adverse short-term outcomes.
- Circumferential strain and radial displacement increased, while basal rotation shifted from positive to negative.
Conclusions:
- LVRM undergoes rapid maturation in extremely preterm infants during the first postnatal week.
- Despite dynamic changes, LVRM does not appear to be associated with adverse short-term neurological outcomes or early brain injury.
- These findings suggest that right ventricular function plays a more predominant role in transitional hemodynamics and cardio-cerebral interactions in this population.
Background:
brain injury in extremely preterm infants has been mainly linked to right ventricular (RV) dysfunction during postnatal transition, whereas the contribution of left ventricular rotational mechanics (LVRM) remains undefined. We aimed to characterize early postnatal evolution of LVRM and compare it between infants with and without adverse short-term outcome.
Methods:
prospective observational cohort study. Targeted echocardiography was conducted within the first 24 h, at 24-72 h and on day 7. LV circumferential strain, radial displacement, basal/apical rotation, twist and torsion were evaluated using speckle-tracking. Adverse outcome was defined as the composite of death and/or adverse short-term neurological outcome, including significant interventricular hemorrhage, or white matter injury.
Results:
among 63 infants, 29 (46%) presented the adverse outcome. During the first week, circumferential strain increased at all levels, radial displacement rose after 24 h and basal rotation shifted from mildly positive to negative. Apical rotation remained stable. LV twist and torsion increased within 72 h and then plateaued. No differences in LVRM parameters were noted between outcome groups.
Conclusions:
LVRM undergoes rapid maturation during early transition in extremely preterm infants. However, it is not associated with adverse outcome, consistent with a predominant role of RV function during this period.
Impact:
Left ventricular rotational mechanics (LVRM) demonstrate rapid maturation during the first postnatal week in extremely preterm infants, but do not differ between those with and without adverse short-term neurological outcome. This prospective longitudinal study shows that, despite dynamic changes in deformation and twist mechanics, LVRM is not associated with early brain injury or cerebral perfusion indices in ELGANs. The findings suggest limited early prognostic value of LVRM and reinforce the predominant role of right ventricular function in transitional hemodynamics and cardio-cerebral interactions in extremely preterm infants.
