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Is myocardial performance index useful in differential diagnosis of moderate and severe hypoxic–ischaemic encephalopathy? A serial Doppler echocardiographic evaluation

Published online by Cambridge University Press:  13 February 2012

Sevim Karaarslan ,
Hayrullah Alp ,
Tamer Baysal ,
Derya Çimen ,
Rahmi Örs  and
Bülent Oran
Sevim Karaarslan
Affiliation:
Department of Pediatric Cardiology, Meram Medical Faculty, Selcuk University, Konya, Turkey
Hayrullah Alp*
Affiliation:
Department of Pediatric Cardiology, Meram Medical Faculty, Selcuk University, Konya, Turkey
Tamer Baysal
Affiliation:
Department of Pediatric Cardiology, Meram Medical Faculty, Selcuk University, Konya, Turkey
Derya Çimen
Affiliation:
Department of Pediatric Cardiology, Meram Medical Faculty, Selcuk University, Konya, Turkey
Rahmi Örs
Affiliation:
Department of Neonatology, Department of Pediatrics, Konya University, Meram School of Medicine Hospital, Konya, Turkey
Bülent Oran
Affiliation:
Department of Pediatric Cardiology, Meram Medical Faculty, Selcuk University, Konya, Turkey
*
Correspondence to: Dr H. Alp, Department of Pediatric Cardiology, Meram Medical Faculty, Selcuk University, Konya, Turkey. Tel: +90 332 223 6429; Fax: +90 332 223 6585; E-mail: drhayrullahalp@hotmail.com
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Abstract

Introduction

The aim of this study was to investigate the importance of myocardial performance index as an additive criterion to Sarnat criteria in differential diagnosis of newborn babies with moderate and severe hypoxic–ischaemic encephalopathy.

Methods

Our study group included 50 healthy term newborn babies and 20 newborn babies with hypoxic–ischaemic encephalopathy. The 20 newborn babies with hypoxic–ischaemic encephalopathy were scored using Sarnat grades. Left and right ventricular functions were determined on the first day and thereafter in the 1, 3–4, 6–7, and 11–12 months of life by M-Mode and pulsed Doppler.

Results

Myocardial performance indexes of the left ventricle were significantly higher in the severe hypoxic–ischaemic encephalopathy group than in the control group during the first, second, and third analyses (p = 0.01, p = 0.02, p = 0.02, respectively) and only during the first analysis (p = 0.01) in the moderate hypoxic–ischaemic encephalopathy group. In addition, the myocardial performance indexes of the right ventricle were significantly higher during the first, second, and third analyses in both severe and moderate hypoxic–ischaemic encephalopathy groups than in the control group (p = 0.01, all). Hypoxia-induced alterations last longer in the right ventricle than in the left ventricle in the moderate group, as during the second and third analyses myocardial performance index continues to be higher than the control group.

Conclusion

Myocardial performance indexes for the left and right ventricles were significantly higher in both severe and moderate hypoxic–ischaemic encephalopathy groups than in the control group during the first analysis, and myocardial performance index greater than or equal to 0.5 can be used in order to distinguish moderate and severe hypoxic–ischaemic encephalopathy babies according to Sarnat grades as a discriminative additive criterion.

Keywords

Sarnat gradesnewbornspulsed Doppler echocardiographyTei index
Type
Original Article
Information
Cardiology in the Young , Volume 22 , Issue 3 , June 2012 , pp. 335 - 340
Copyright
Copyright © Cambridge University Press 2012

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