Clinical InvestigationHeart Disease in Infants and ChildrenMaturational Patterns of Systolic Ventricular Deformation Mechanics by Two-Dimensional Speckle-Tracking Echocardiography in Preterm Infants over the First Year of Age
Section snippets
Study Population
All data were prospectively obtained as part of an observational research study that included patients who were enrolled between August 2011 and January 2016 at hospitals affiliated with two academic institutions (Washington University School of Medicine, St. Louis Children's Hospital, and the Royal College of Surgeons in Ireland, Rotunda Hospital). Two hundred thirty-nine preterm infants (born at 23-0/7 to 28-6/7 weeks gestation) were recruited at birth and longitudinally followed until 1 year
Study Population Characteristics
Two hundred thirty-nine infants with a median gestational age of 27.0 weeks (interquartile range, 26.0–28.0 weeks) and a median birth weight of 960 g (interquartile range, 800–1,138 g) were recruited in this study (137 patients from the Washington University site and 102 patients from the Royal College of Surgeons site). Of the 239 patients, 17 infants (7% with equal distribution among centers) died before hospital discharge and were excluded from the analysis, leaving 222 infants with data to
Discussion
In a prospective multicenter longitudinal study of a large cohort of premature infants (≤29 weeks at birth), we evaluated ventricular mechanics with 2D STE–derived deformational indices from birth to 1 year CA to determine the maturational patterns of postnatal cardiac adaptation. The main findings of this study are as follows: (1) RV LS has a distinct regional magnitude distribution with a base-to-apex gradient and an incremental progression, while LV strain has an apex-to-base magnitude
Conclusions
In this study we tracked the maturational patterns of ventricular mechanics with global and regional deformation imaging by 2D STE in extremely preterm infants during the first year of age. The maturational patterns are ventricular specific. It appears that BPD and PH have a negative impact on RV and IVS strain, while LV strain remains stable through the first year of age, independent of birth weight, postnatal age, and clinical status. This study suggests that 2D STE–derived strain can be used
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This study was supported by grants from the Premature and Respiratory Outcomes Program (National Institutes of Health [NIH] grants 1U01 HL1014650 and U01 HL101794), NIH grant R21 HL106417, the Pediatric Physician Scientist Training Grant (NIH grant 5 T32 HD043010-09), and the Postdoctoral Mentored Training Program in Clinical Investigation (NIH grant UL1 TR000448). Dr. EL-Khuffash is funded by multiple sources: EU FP7/2007-2013 grant (agreement no. 260777, The HIP Trial), the Friends of the Rotunda Research Grant (reference: FoR/EQUIPMENT/101572), and the Health Research Board Mother and Baby Clinical Trials Network Ireland (CTN-2014-10). Drs. Levy and El-Khuffash equally contributed to writing the first draft of this report.