Left Ventricular Function in Healthy Term Neonates During the Transitional Period

Abstract

Objectives: To evaluate whether incorporating conventional, tissue Doppler imaging and speckle tracking echocardiography are reliable and can characterize changes in left ventricular (LV) function properly in healthy neonates in the early transitional newborn period.

Study design: A prospective observational study was conducted in 50 healthy term neonates with a mean ± SD gestational age and birth weight of 39.3 ± 1.2 weeks and 3.5 ± 0.44 kg, respectively. All infants underwent serial echocardiograms at 15 ± 2 (day 1) and 35 ± 2 hours (day 2) of age. The LV dimensions and various functional indices including tissue Doppler imaging velocities and speckle tracking echocardiography-derived peak longitudinal strain, and systolic and diastolic strain rate were acquired and compared between time points.

Results: All measurements were feasible from each scan except speckle tracking echocardiography in 10% and 20% of images on days 1 and 2 of age, respectively. LV dimensions, but not functional measures, demonstrated a small to moderate positive correlation with birth weight. On day 2, a small reduction was observed in LV basal diameter, mitral valve inflow velocity time integral, and systolic velocity of the lateral wall and septum. Other indices remained unchanged. Tissue Doppler imaging-derived functional and flow-derived hemodynamic measures demonstrated the least measurement bias, and strain measurements demonstrated better reliability than strain rate, fractional shortening, and ejection fraction.

Conclusion: The relative reliability of various echocardiographic indices to quantify LV function in neonates establish a normative dataset and provide evidence for their validity during the first 2 days of life.

Keywords: newborn; speckle tracking echocardiography; tissue Doppler imaging.