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Cardiovascular adaptation to extrauterine life after intrauterine growth restriction

Published online by Cambridge University Press:  30 October 2017

Luciana Rodriguez-Guerineau Open the ORCID record for Luciana Rodriguez-Guerineau [Opens in a new window] ,
Miriam Perez-Cruz ,
María D. Gomez Roig ,
Francisco J. Cambra ,
Juan Carretero ,
Fredy Prada ,
Olga Gómez ,
Fátima Crispi  and
Joaquim Bartrons
Luciana Rodriguez-Guerineau*
Affiliation:
Pediatric Cardiology Department, Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain Pediatric Intensive Care Unit, Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain
Miriam Perez-Cruz
Affiliation:
Barcelona Center for Maternal Fetal and Neonatal Medicine Hospital Clínic and Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain
María D. Gomez Roig
Affiliation:
Barcelona Center for Maternal Fetal and Neonatal Medicine Hospital Clínic and Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain
Francisco J. Cambra
Affiliation:
Pediatric Intensive Care Unit, Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain
Juan Carretero
Affiliation:
Pediatric Cardiology Department, Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain
Fredy Prada
Affiliation:
Pediatric Cardiology Department, Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain
Olga Gómez
Affiliation:
Barcelona Center for Maternal Fetal and Neonatal Medicine Hospital Clínic and Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain
Fátima Crispi
Affiliation:
Barcelona Center for Maternal Fetal and Neonatal Medicine Hospital Clínic and Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain
Joaquim Bartrons
Affiliation:
Pediatric Cardiology Department, Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain
*
Correspondence to: L. Rodriguez-Guerineau, MD, Pediatric Cardiology Department, Hospital Sant Joan de Déu, Universitat de Barcelona, Passeig Sant Joan de Déu 2, 08950 Esplugues de Llobregat, Barcelona, Spain. Tel: +34 932 53 21 00; Fax: +34 932 03 39 59; E-mail: lrodriguez@hsjdbcn.org
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Abstract

Introduction

The adaptive changes of the foetal heart in intrauterine growth restriction can persist postnatally. Data regarding its consequences for early circulatory adaptation to extrauterine life are scarce. The aim of this study was to assess cardiac morphometry and function in newborns with late-onset intrauterine growth restriction to test the hypothesis that intrauterine growth restriction causes cardiac shape and functional changes at birth.

Methods

A comprehensive echocardiographic study was performed in 25 neonates with intrauterine growth restriction and 25 adequate-for-gestational-age neonates.

Results

Compared with controls, neonates with intrauterine growth restriction had more globular ventricles, lower longitudinal tricuspid annular motion, and higher left stroke volume without differences in the heart rate. Neonates with intrauterine growth restriction also showed subclinical signs of diastolic dysfunction in the tissue Doppler imaging with lower values of early (e′) diastolic annular peak velocities in the septal annulus. Finally, the Tei index in the tricuspid annulus was higher in the intrauterine growth restriction group.

Conclusion

Neonates with history of intrauterine growth restriction showed cardiac remodelling and signs of systolic and diastolic dysfunction. Overall, there was a significant tendency to worse cardiac function results in the right heart. The adaptation to extrauterine life occurred with more globular hearts, higher stroke volumes but a similar heart rate compared to adequate-for-gestational-age neonates.

Keywords

Intrauterine growth restrictioncardiac functioncardiac remodellingtissue Doppler imagingneonate
Type
Original Articles
Information
Cardiology in the Young , Volume 28 , Issue 2 , February 2018 , pp. 284 - 291
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Copyright
© Cambridge University Press 2017 

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