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Maturational Patterns of Systolic Ventricular Deformation Mechanics by Two-Dimensional Speckle-Tracking Echocardiography in Preterm Infants over the First Year of Age.
J Am Soc Echocardiogr. 2017 Jul; 30(7):685-698.e1.JA

Abstract

BACKGROUND

The aim of this study was to determine the maturational changes in systolic ventricular strain mechanics by two-dimensional speckle-tracking echocardiography in extremely preterm neonates from birth to 1 year of age and discern the impact of common cardiopulmonary abnormalities on the deformation measures.

METHODS

In a prospective multicenter study of 239 extremely preterm infants (<29 weeks gestation at birth), left ventricular (LV) global longitudinal strain (GLS) and global longitudinal systolic strain rate (GLSRs), interventricular septal wall (IVS) GLS and GLSRs, right ventricular (RV) free wall longitudinal strain and strain rate, and segmental longitudinal strain in the RV free wall, LV free wall, and IVS were serially measured on days 1, 2, and 5 to 7, at 32 and 36 weeks postmenstrual age, and at 1 year corrected age (CA). Premature infants who developed bronchopulmonary dysplasia or had echocardiographic findings of pulmonary hypertension were analyzed separately.

RESULTS

In uncomplicated preterm infants (n = 103 [48%]), LV GLS and GLSRs remained unchanged from days 5 to 7 to 1 year CA (P = .60 and P = .59). RV free wall longitudinal strain, RV free wall longitudinal strain rate, and IVS GLS and GLSRs significantly increased over the same time period (P < .01 for all measures). A significant base-to-apex (highest to lowest) segmental longitudinal strain gradient (P < .01) was seen in the RV free wall and a reverse apex-to-base gradient (P < .01) in the LV free wall. In infants with bronchopulmonary dysplasia and/or pulmonary hypertension (n = 119 [51%]), RV free wall longitudinal strain and IVS GLS were significantly lower (P < .01), LV GLS and GLSRs were similar (P = .56), and IVS segmental longitudinal strain persisted as an RV-dominant base-to-apex gradient from 32 weeks postmenstrual age to 1 year CA.

CONCLUSIONS

This study tracks the maturational patterns of global and regional deformation by two-dimensional speckle-tracking echocardiography in extremely preterm infants from birth to 1 year CA. The maturational patterns are ventricular specific. Bronchopulmonary dysplasia and pulmonary hypertension leave a negative impact on RV and IVS strain, while LV strain remains stable.

Authors+Show Affiliations

Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri; Department of Pediatrics, Goryeb Children's Hospital, Morristown, New Jersey. Electronic address: levy_p@kids.wustl.edu.Department of Neonatology, The Rotunda Hospital, Dublin, Ireland; School of Medicine, Department of Paediatrics, Royal College of Surgeons in Ireland, Dublin, Ireland.Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri.Department of Neonatology, The Rotunda Hospital, Dublin, Ireland.Department of Neonatology, The Rotunda Hospital, Dublin, Ireland.Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota.Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri.Department of Pediatrics, Goryeb Children's Hospital, Morristown, New Jersey.Department of Radiology and Imaging Sciences, Indiana University Purdue University, Indianapolis, Indiana.Division of Neonatology and Department of Physiology, The Hospital for Sick Children, Toronto, Ontario, Canada.Department of Paediatrics, Mount Sinai Hospital, Toronto, Ontario, Canada.Department of Cardiology, Our Lady's Children's Hospital Crumlin, Dublin, Ireland.Division of Cardiology, The Labatt Family Heart Centre, The Hospital for Children, Toronto, Ontario, Canada.Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois.Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri.

Pub Type(s)

Journal Article
Multicenter Study

Language

eng

PubMed ID

28433214

Citation

Levy, Philip T., et al. "Maturational Patterns of Systolic Ventricular Deformation Mechanics By Two-Dimensional Speckle-Tracking Echocardiography in Preterm Infants Over the First Year of Age." Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography, vol. 30, no. 7, 2017, pp. 685-698.e1.
Levy PT, El-Khuffash A, Patel MD, et al. Maturational Patterns of Systolic Ventricular Deformation Mechanics by Two-Dimensional Speckle-Tracking Echocardiography in Preterm Infants over the First Year of Age. J Am Soc Echocardiogr. 2017;30(7):685-698.e1.
Levy, P. T., El-Khuffash, A., Patel, M. D., Breatnach, C. R., James, A. T., Sanchez, A. A., Abuchabe, C., Rogal, S. R., Holland, M. R., McNamara, P. J., Jain, A., Franklin, O., Mertens, L., Hamvas, A., & Singh, G. K. (2017). Maturational Patterns of Systolic Ventricular Deformation Mechanics by Two-Dimensional Speckle-Tracking Echocardiography in Preterm Infants over the First Year of Age. Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography, 30(7), 685-e1. https://doi.org/10.1016/j.echo.2017.03.003
Levy PT, et al. Maturational Patterns of Systolic Ventricular Deformation Mechanics By Two-Dimensional Speckle-Tracking Echocardiography in Preterm Infants Over the First Year of Age. J Am Soc Echocardiogr. 2017;30(7):685-698.e1. PubMed PMID: 28433214.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Maturational Patterns of Systolic Ventricular Deformation Mechanics by Two-Dimensional Speckle-Tracking Echocardiography in Preterm Infants over the First Year of Age. AU - Levy,Philip T, AU - El-Khuffash,Afif, AU - Patel,Meghna D, AU - Breatnach,Colm R, AU - James,Adam T, AU - Sanchez,Aura A, AU - Abuchabe,Cristina, AU - Rogal,Sarah R, AU - Holland,Mark R, AU - McNamara,Patrick J, AU - Jain,Amish, AU - Franklin,Orla, AU - Mertens,Luc, AU - Hamvas,Aaron, AU - Singh,Gautam K, Y1 - 2017/04/19/ PY - 2016/09/16/received PY - 2017/4/24/pubmed PY - 2018/5/15/medline PY - 2017/4/24/entrez KW - Cardiac function KW - Echocardiography KW - Prematurity KW - Strain imaging SP - 685 EP - 698.e1 JF - Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography JO - J Am Soc Echocardiogr VL - 30 IS - 7 N2 - BACKGROUND: The aim of this study was to determine the maturational changes in systolic ventricular strain mechanics by two-dimensional speckle-tracking echocardiography in extremely preterm neonates from birth to 1 year of age and discern the impact of common cardiopulmonary abnormalities on the deformation measures. METHODS: In a prospective multicenter study of 239 extremely preterm infants (<29 weeks gestation at birth), left ventricular (LV) global longitudinal strain (GLS) and global longitudinal systolic strain rate (GLSRs), interventricular septal wall (IVS) GLS and GLSRs, right ventricular (RV) free wall longitudinal strain and strain rate, and segmental longitudinal strain in the RV free wall, LV free wall, and IVS were serially measured on days 1, 2, and 5 to 7, at 32 and 36 weeks postmenstrual age, and at 1 year corrected age (CA). Premature infants who developed bronchopulmonary dysplasia or had echocardiographic findings of pulmonary hypertension were analyzed separately. RESULTS: In uncomplicated preterm infants (n = 103 [48%]), LV GLS and GLSRs remained unchanged from days 5 to 7 to 1 year CA (P = .60 and P = .59). RV free wall longitudinal strain, RV free wall longitudinal strain rate, and IVS GLS and GLSRs significantly increased over the same time period (P < .01 for all measures). A significant base-to-apex (highest to lowest) segmental longitudinal strain gradient (P < .01) was seen in the RV free wall and a reverse apex-to-base gradient (P < .01) in the LV free wall. In infants with bronchopulmonary dysplasia and/or pulmonary hypertension (n = 119 [51%]), RV free wall longitudinal strain and IVS GLS were significantly lower (P < .01), LV GLS and GLSRs were similar (P = .56), and IVS segmental longitudinal strain persisted as an RV-dominant base-to-apex gradient from 32 weeks postmenstrual age to 1 year CA. CONCLUSIONS: This study tracks the maturational patterns of global and regional deformation by two-dimensional speckle-tracking echocardiography in extremely preterm infants from birth to 1 year CA. The maturational patterns are ventricular specific. Bronchopulmonary dysplasia and pulmonary hypertension leave a negative impact on RV and IVS strain, while LV strain remains stable. SN - 1097-6795 UR - https://www.unboundmedicine.com/medline/citation/28433214/Maturational_Patterns_of_Systolic_Ventricular_Deformation_Mechanics_by_Two_Dimensional_Speckle_Tracking_Echocardiography_in_Preterm_Infants_over_the_First_Year_of_Age_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0894-7317(17)30181-5 DB - PRIME DP - Unbound Medicine ER -