Abnormal left ventricular diastolic filling patterns in small-for-gestational-age infants

Area of Science:

• Pediatric Cardiology
• Neonatal Physiology
• Echocardiography

Background:

• Assessing left ventricular diastolic function in small-for-gestational-age (SGA) infants using Doppler transmitral flow velocity patterns is not well understood.
• Diastolic dysfunction can have long-term implications for cardiovascular health.

Purpose of the Study:

• To investigate Doppler filling patterns in SGA infants.
• To compare these patterns with age-matched appropriate-for-gestational-age (AGA) infants.

Main Methods:

• Echocardiographic assessment of Doppler transmitral flow velocity parameters.
• Comparison of peak early diastolic (E) and atrial contraction (A) waves, E/A ratio, velocity time integrals (VTIE, VTIA), filling fractions, peak filling rates, and deceleration times.
• Statistical analysis comparing SGA (n=13) and AGA (n=29) infants, controlling for body weight.

Main Results:

• SGA infants had significantly lower peak E wave, peak A wave, peak E/A wave, VTIE wave, first third filling fraction, and peak filling rate normalized to stroke volume compared to AGA infants.
• While E wave parameters increased with body weight in both groups, the slopes were significantly lower in SGA infants, indicating reduced E wave velocity independent of size.
• No significant differences in mean gestational age or heart rate were observed.

Conclusions:

• SGA infants exhibit significantly reduced early diastolic filling.
• These findings suggest impaired left ventricular diastolic function in SGA infants.
• Doppler transmitral flow velocity patterns provide valuable insights into diastolic function in neonates.