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Left ventricular ejection fraction using manual and semi-automated biplane method of discs in very preterm infants.
Echocardiography. 2020 Jul 03 [Online ahead of print]E

Abstract

BACKGROUND

Biplane left ventricular ejection fraction (LVEF) is a valuable echocardiographic parameter for assessment of LV systolic pump efficiency in adults and children, but not often reported in preterm infants. The primary aim of this study was to longitudinally measure biplane LVEF in very preterm infants during the neonatal intensive care period. Secondary aim was to compare manual and semi-automatic determination of LVEF for agreement and variability.

METHODS

Stable preterm infants less than 30 weeks gestation were scanned on day 3, day 28, and at 36 weeks postmenstrual age. The LV endocardium was traced manually and semi-automatically using integrated speckle tracking software in apical 4-chamber and apical 3-chamber images to obtain end-diastolic volume and end-systolic volume, and calculate LVEF. Agreement between methods and variability within and between observers was determined using an interclass correlation coefficient (ICC) and Bland-Altman analysis.

RESULTS

Sixty-six preterm infants with a mean birth weight of 1100 (239) g were analyzed. The average manual biplane LVEF was 58 (3)%, 59 (3)%, and 55 (4)% at the three respective time points. Manual LVEF showed good agreement with semi-automatic LVEF (ICC 0.76) with a small bias of -1.5 (3.0)%. Interobserver variability of LVEF improved with semi-automatic tracing of the LV endocardial border (ICC manual 0.68 vs semi-automatic 0.80).

CONCLUSION

Left ventricular systolic pump efficiency in preterm infants remains stable during the neonatal intensive care period. Semi-automatic biplane LVEF has less interobserver variability and can be used interchangeably with manual biplane LVEF.

Authors+Show Affiliations

John Hunter Children's Hospital, University of Newcastle, Newcastle, NSW, Australia.John Hunter Children's Hospital, University of Newcastle, Newcastle, NSW, Australia.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32618392

Citation

Phad, Nilkant, and Koert de Waal. "Left Ventricular Ejection Fraction Using Manual and Semi-automated Biplane Method of Discs in Very Preterm Infants." Echocardiography (Mount Kisco, N.Y.), 2020.
Phad N, de Waal K. Left ventricular ejection fraction using manual and semi-automated biplane method of discs in very preterm infants. Echocardiography. 2020.
Phad, N., & de Waal, K. (2020). Left ventricular ejection fraction using manual and semi-automated biplane method of discs in very preterm infants. Echocardiography (Mount Kisco, N.Y.). https://doi.org/10.1111/echo.14784
Phad N, de Waal K. Left Ventricular Ejection Fraction Using Manual and Semi-automated Biplane Method of Discs in Very Preterm Infants. Echocardiography. 2020 Jul 3; PubMed PMID: 32618392.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Left ventricular ejection fraction using manual and semi-automated biplane method of discs in very preterm infants. AU - Phad,Nilkant, AU - de Waal,Koert, Y1 - 2020/07/03/ PY - 2020/01/01/received PY - 2020/06/01/revised PY - 2020/06/09/accepted PY - 2020/7/4/entrez KW - cardiac function KW - cardiovascular compromise KW - ejection fraction KW - preterm infants KW - speckle tracking JF - Echocardiography (Mount Kisco, N.Y.) JO - Echocardiography N2 - BACKGROUND: Biplane left ventricular ejection fraction (LVEF) is a valuable echocardiographic parameter for assessment of LV systolic pump efficiency in adults and children, but not often reported in preterm infants. The primary aim of this study was to longitudinally measure biplane LVEF in very preterm infants during the neonatal intensive care period. Secondary aim was to compare manual and semi-automatic determination of LVEF for agreement and variability. METHODS: Stable preterm infants less than 30 weeks gestation were scanned on day 3, day 28, and at 36 weeks postmenstrual age. The LV endocardium was traced manually and semi-automatically using integrated speckle tracking software in apical 4-chamber and apical 3-chamber images to obtain end-diastolic volume and end-systolic volume, and calculate LVEF. Agreement between methods and variability within and between observers was determined using an interclass correlation coefficient (ICC) and Bland-Altman analysis. RESULTS: Sixty-six preterm infants with a mean birth weight of 1100 (239) g were analyzed. The average manual biplane LVEF was 58 (3)%, 59 (3)%, and 55 (4)% at the three respective time points. Manual LVEF showed good agreement with semi-automatic LVEF (ICC 0.76) with a small bias of -1.5 (3.0)%. Interobserver variability of LVEF improved with semi-automatic tracing of the LV endocardial border (ICC manual 0.68 vs semi-automatic 0.80). CONCLUSION: Left ventricular systolic pump efficiency in preterm infants remains stable during the neonatal intensive care period. Semi-automatic biplane LVEF has less interobserver variability and can be used interchangeably with manual biplane LVEF. SN - 1540-8175 UR - https://www.unboundmedicine.com/medline/citation/32618392/Left_ventricular_ejection_fraction_using_manual_and_semi-automated_biplane_method_of_discs_in_very_preterm_infants L2 - https://doi.org/10.1111/echo.14784 DB - PRIME DP - Unbound Medicine ER -
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