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Reference ranges for cardiac dimensions and blood flow velocity in preterm infants
R Skelton1, A B Gill, J M Parsons
1Peter Congden Neonatal Intensive Care Unit, Leeds General Infirmary, UK.
Insights
This study establishes cardiac reference ranges for preterm infants, showing dimensions correlate with gestation and weight. Echocardiographic measurements change significantly in the first month of life.
Area of Science:
- Neonatal cardiology
- Pediatric echocardiography
Background:
- Establishing normative cardiac data is crucial for identifying abnormalities in preterm infants.
- Preterm infants have unique physiological characteristics that may influence cardiac development and function.
Purpose of the Study:
- To define reference ranges for cardiac dimensions and Doppler flow velocities in preterm infants.
- To track changes in these cardiac parameters during the first month of life.
Main Methods:
- Echocardiography was performed on 79 preterm infants (<34 weeks gestation) at days 0, 7, and 28 post-birth.
- Measurements included interventricular septum, left ventricular dimensions, left atrium, aortic root, and peak flow velocities through major valves.
- Correlation with gestational age, birth weight, and antenatal dexamethasone exposure was assessed.
Main Results:
- Reference ranges for cardiac dimensions and Doppler measurements were established.
- Cardiac dimensions showed a strong correlation with gestational age and birth weight.
- Measurements increased significantly over the first month; asymmetrical septal hypertrophy was common.
- Peak flow velocities (Vmax) did not correlate with gestational age or birth weight.
Conclusions:
- Cardiac dimensions in preterm infants are closely linked to gestational age and birth weight.
- Echocardiographic findings in preterm infants differ significantly from those in older children and adults.
- These reference ranges aid in the accurate assessment of cardiac health in neonates.
Aim:
To establish reference ranges for cardiac dimensions and Doppler measurements in preterm infants.
Methods:
79 infants of less than 34 weeks' gestation were examined by echocardiography on days 0, 7, and 28 after birth, to produce a set of reference ranges and to examine changes in these indices over the first month of life. The following dimensions were measured: interventricular septum, left ventricular posterior wall, left interventricular diameter at end systole and diastole, left atrium, and aortic root; Doppler measurements were made of maximum blood flow velocity (Vmax) through the pulmonary, aortic, mitral, and tricuspid valves.
Results:
Reference ranges are given. Cardiac dimensions correlated well with gestation and birth weight but Vmax did not. There was a significant increase in measurements over time. The "normal" preterm infant also appeared to often have asymmetrical septal hypertrophy. Antenatal dexamethasone administration did not appear to affect the measurements.
Conclusions:
There is a close correlation with both gestation and birth weight for all physical measurements. Echocardiograms in preterm babies clearly differ from those in older children and adults.