Left Ventricle Phenotyping Utilizing Tissue Doppler Imaging in Premature Infants with Varying Severity of Bronchopulmonary Dysplasia.
Eunice TorresPhillip T LevyAfif Faisal El-KhuffashHongjie GuAaron HamvasGautam K SinghPublished in: Journal of clinical medicine (2021)
Bronchopulmonary dysplasia (BPD) is characterized by alveolar-capillary simplification and is associated with pulmonary hypertension (PH) in preterm infants. The contribution of left ventricle (LV) disease towards this severe BPD-PH phenotype is not well established. We aimed to describe the longitudinal trajectory of the LV function as measured by tissue Doppler imaging (TDI) and its association with BPD-PH. We retrospectively assessed prospectively acquired clinical and echocardiographic data from 77 preterm infants born between 2011 and 2013. We characterized the LV function by measuring systolic and diastolic myocardial velocities (s', e', a'), isovolumetric relaxation time (IVRT), and myocardial performance index with TDI at three time periods from 32 and 36 weeks, postmenstrual age through one year of age. We also measured post systolic motion (PSM), a marker of myocardial dysfunction that results from asynchronous movement of the ventricular walls, and not previously described in preterm infants. Patients were stratified into groups according to BPD severity and the presence of PH and compared over time. Conventional TDI measures of the LV function were similar between groups, but the septal PSM was significantly prolonged over the first year of age in patients with BPD-PH. PSM provides a novel objective way to assess the hemodynamic impact of lung and pulmonary vascular disease severity on LV function in preterm infants with BPD and PH.
Keyphrases
- preterm infants
- left ventricular
- pulmonary hypertension
- low birth weight
- mitral valve
- heart failure
- hypertrophic cardiomyopathy
- blood pressure
- pulmonary artery
- ejection fraction
- high resolution
- end stage renal disease
- pulmonary arterial hypertension
- left atrial
- blood flow
- chronic kidney disease
- oxidative stress
- preterm birth
- early onset
- coronary artery
- gestational age
- congenital heart disease
- artificial intelligence
- machine learning
- high throughput
- high speed
- big data
- photodynamic therapy
- patient reported outcomes