Hostname: page-component-76fb5796d-skm99 Total loading time: 0 Render date: 2024-04-27T00:22:49.564Z Has data issue: false hasContentIssue false
  • English
  • Français

Maturational patterns of left ventricular rotational mechanics in pre-term infants through 1 year of age

Published online by Cambridge University Press:  15 July 2020

Gloria C. Lehmann Open the ORCID record for Gloria C. Lehmann [Opens in a new window] ,
Philip T. Levy Open the ORCID record for Philip T. Levy [Opens in a new window] ,
Meghna D. Patel ,
Timothy Sekarski ,
HongJie Gu ,
Swati Choudhry ,
Aaron Hamvas  and
Gautam K. Singh
Gloria C. Lehmann*
Affiliation:
Division of Pediatric Cardiology, Department of Pediatrics, Saint Louis University School of Medicine, Saint LouisMO, USA
Philip T. Levy
Affiliation:
Division of Newborn Medicine, Department of Pediatrics, Harvard Medical School, Boston Children’s Hospital, BostonMA, USA
Meghna D. Patel
Affiliation:
Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
Timothy Sekarski
Affiliation:
Department of Pediatrics, Washington University School of Medicine, Saint Louis, MO, USA
HongJie Gu
Affiliation:
Division of Biostatistics, Washington University School of Medicine, Saint LouisMO, USA
Swati Choudhry
Affiliation:
Section of Pediatric Cardiology, Department of Pediatrics, Baylor College of Medicine, HoustonTX, USA
Aaron Hamvas
Affiliation:
Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
Gautam K. Singh
Affiliation:
Department of Pediatrics, Washington University School of Medicine, Saint Louis, MO, USA Department of Pediatrics, Wayne State University School of Medicine, Detroit, MI, USA
*
Author for correspondence: Gloria C. Lehmann, MD, Division of Pediatric Cardiology, Saint Louis University School of Medicine, 1465 South Grand Blvd,Saint Louis, MO, USA. Tel: +1 314-577-5674. E-mail: Gloria.Lehmann@health.slu.edu
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

Pre-mature birth impacts left ventricular development, predisposing this population to long-term cardiovascular risk. The aims of this study were to investigate maturational changes in rotational properties from the neonatal period through 1 year of age and to discern the impact of cardiopulmonary complications of pre-maturity on these measures.

Methods:

Pre-term infants (<29 weeks at birth, n = 117) were prospectively enrolled and followed to 1-year corrected age. Left ventricular basal and apical rotation, twist, and torsion were measured by two-dimensional speckle-tracking echocardiography and analysed at 32 and 36 weeks post-menstrual age and 1-year corrected age. A mixed random effects model with repeated measures analysis was used to compare rotational mechanics over time. Torsion was compared in infants with and without complications of cardiopulmonary diseases of pre-maturity, specifically bronchopulmonary dysplasia, pulmonary hypertension, and patent ductus arteriosus.

Results:

Torsion decreased from 32 weeks post-menstrual age to 1-year corrected age in all pre-term infants (p < 0.001). The decline from 32 to 36 weeks post-menstrual age was more pronounced in infants with cardiopulmonary complications, but was similar to healthy pre-term infants from 36 weeks post-menstrual age to 1-year corrected age. The decline was due to directional and magnitude changes in apical rotation over time (p < 0.05).

Conclusion:

This study tracks maturational patterns of rotational mechanics in pre-term infants and reveals torsion declines from the neonatal period through 1 year. Cardiopulmonary diseases of pre-maturity may negatively impact rotational mechanics during the neonatal period, but the myocardium recovers by 1-year corrected age.

Keywords

Cardiac functionpre-maturityrotational straintorsion
Type
Original Article
Information
Cardiology in the Young , Volume 30 , Issue 9 , September 2020 , pp. 1238 - 1246
Copyright
© The Author(s), 2020. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Carr, H, Cnattingius, S, Granath, F, Ludvigsson, JF, Edstedt Bonamy, AK.Preterm birth and risk of heart failure up to early adulthood. J Am Coll Cardiol 2017; 69: 2634–2642.CrossRefGoogle ScholarPubMed
Crump, C, Howell, EA, Stroustrup, A, McLaughlin, MA, Sundquist, J, Sundquist, K.Association of preterm birth with risk of ischemic heart disease in adulthood. JAMA Pediatr 2019; 173: 736–743.CrossRefGoogle Scholar
Aye, CYL, Lewandowski, AJ, Lamata, P, et al.Disproportionate cardiac hypertrophy during early postnatal development in infants born preterm. Pediatr Res 2017; 82: 36–34.CrossRefGoogle ScholarPubMed
Bensley, JG, Moore, L, De Matteo, R, Harding, R, Black, MJ.Impact of preterm birth on the developing myocardium of the neonate. Pediatr Res 2018; 83: 880–888.CrossRefGoogle ScholarPubMed
Burchert, H, Lewandowski, AJ.Preterm birth is a novel, independent risk factor for altered cardiac remodeling and early heart failure: is it time for a new cardiomyopathy? Curr Treat Options Cardiovasc Med 2019; 21: 8.CrossRefGoogle ScholarPubMed
Bensley, JG, Stacy, VK, De Matteo, R, Harding, R, Black, MJ.Cardiac remodeling as a result of pre-term birth: implications for future cardiovascular disease. Eur Heart J 2010; 3: 2058–2066.CrossRefGoogle Scholar
Mohlkert, LA, Hallberg, J, Broberg, O, et al.The preterm heart in childhood: left ventricular structure, geometry, and function assessed by echocardiography in 6-year-old survivors of periviable births. J Am Heart Assoc 2018; 7: e007742.CrossRefGoogle ScholarPubMed
Breatnach, CR, Levy, PT, James, AT, Franklin, O, El-Khuffash, A.Novel echocardiography methods in the functional assessment of the newborn heart. Neonatology 2016; 110: 248–260.CrossRefGoogle ScholarPubMed
El-Khuffash, AS, Schubert, U, Levy, PT, Nestaas, E, de Boode, WP.European special interest group neonatologist performed, echocardiography. Deformation imaging and rotational mechanics in neonates: a guide to image acquisition, measurement, interpretation, and reference values. Pediatr Res 2018; 84: 30–45.CrossRefGoogle ScholarPubMed
Sedmera, D.Form follows function: developmental and physiological view on ventricular myocardial architecture. Eur J Cardiothorac Surg 2005; 28: 526–528.CrossRefGoogle ScholarPubMed
Notomi, Y, Srinath, G, Shiota, T, et al.Maturational and adaptive modulation of left ventricular torsional biomechanics: doppler tissue imaging observation from infancy to adulthood. Circulation 2006; 113: 2534–2541.CrossRefGoogle Scholar
James, A, Corcoran, JD, Mertens, L, Franklin, O, El-Khuffash, A.Left ventricular rotational mechanics in preterm infants less than 29 weeks’ gestation over the first week after birth. J Am Soc Echocardiogr 2015; 28: 808–817.CrossRefGoogle ScholarPubMed
Breatnach, CR, Forman, E, Foran, A, et al.Left ventricular rotational mechanics in infants with hypoxic ischemic encephalopathy and preterm infants at 36 weeks postmenstrual age: a comparison with healthy term controls. Echocardiography 2017; 34: 232–239.CrossRefGoogle ScholarPubMed
James, AT, Corcoran, JD, Hayes, B, Franklin, O, EL-Khuffash a. The effect of antenatal magnesium sulfate on left ventricular afterload and myocardial function measured using deformation and rotational mechanics imaging. Pediatr Res 2015; 35: 913–918.Google ScholarPubMed
LeGrice, IJ, Smaill, BH, Chai, LZ, Edgar, SG, Gavin, JB, Hunter, PJ.Laminar structure of the heart: ventricular myocyte arrangement and connective tissue architecture in the dog. Am J Physiol 1995; 269: H571–H582.Google ScholarPubMed
Levy, PT, El-Khuffash, A, Patel, MD, et al.Maturational patterns of systolic ventricular deformation mechanics by two-dimensional speckle-tracking echocardiography in preterm infants over the first year of age. J Am Soc Echocardiogr 2017; 30: 685–698.CrossRefGoogle ScholarPubMed
Pryhuber, GS, Maitre, NL, Ballard, RA, et al.Prematurity and respiratory outcomes program (PROP): study protocol of a prospective multicenter study of respiratory outcomes of preterm infants in the United States. BMC Pediatr 2015; 15: 37.CrossRefGoogle ScholarPubMed
James, AT, Corcoran, JD, Franklin, O, EL-Khuffash AF. Clinical utility of right ventricular fractional area change in preterm infants. Early Hum Dev 2016; 92: 19–23.CrossRefGoogle ScholarPubMed
Levy, PT, Dioneda, B, Holland, MR, et al.Right ventricular function in preterm and term neonates: reference values for right ventricle areas and fractional area of change. J Am Soc Echocardiogr 2015; 28: 559–569.CrossRefGoogle ScholarPubMed
Levy, PT, Holland, MR, Sekarski, TJ, Hamvas, A, Singh, GK.Feasibility and reproducibility of systolic right ventricular strain measurement by speckle-tracking echocardiography in premature infants. J Am Soc Echocardiogr 2013; 26: 1201–1213.CrossRefGoogle ScholarPubMed
James, AT, Corcoran, JD, Jain, A, et al.Assessment of myocardial performance in preterm infants less than 29 weeks gestation during the transitional period. Early Hum Dev 2014; 90: 829–835.CrossRefGoogle ScholarPubMed
James, AT, Corcoran, JD, Breatnach, CR, Franklin, O, Mertens, L, El-Khuffash, A.Longitudinal assessment of left and right myocardial function in preterm infants using strain and strain rate imaging. Neonatology 2016; 109: 69–75.CrossRefGoogle ScholarPubMed
Levy, PT, Patel, MD, Choudhry, S, Hamvas, A, Singh, GK.Evidence of echocardiographic markers of pulmonary vascular disease in asymptomatic preterm infants at one year of age. J Pediatr 2018; 197: 48–56.CrossRefGoogle ScholarPubMed
Patel, MD, Breatnach, CR, James, AT, et al.Echocardiographic assessment of right ventricle afterload in preterm infants: maturational patterns of pulmonary artery acceleration time over the first year of age and implications for pulmonary hypertension. J Am Soc Echocardiogr 2019; 32: 884–894.CrossRefGoogle Scholar
Poindexter, BB, Feng, R, Schmidt, B, et al.Comparisons and limitations of current definitions of bronchopulmonary dysplasia for the prematurity and respiratory outcomes program. Ann Am Thorac Soc 2015; 12: 1822–1830.CrossRefGoogle ScholarPubMed
Lang, RM, Badano, LP, Mor-Avi, V, et al.Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American society of echocardiography and the European association of cardiovascular imaging. J Am Soc Echocardiogr 2015; 28: 1–39.CrossRefGoogle ScholarPubMed
Sanchez, AA, Levy, PT, Sekarski, TJ, Hamvas, A, Holland, MR, Singh, GK.Effects of frame rate on two-dimensional speckle tracking–derived measurements of myocardial deformation in premature infants. Echocardiography 2014; 32: 839–847.CrossRefGoogle ScholarPubMed
Kaku, K, Takeuchi, M, Tsang, W, et al.Age-related normal range of left ventricular strain and torsion using three-dimensional speckle-tracking echocardiography. J Am Soc Echocardiogr 2014; 27: 55–64.CrossRefGoogle ScholarPubMed
Moon, MR, Ingels, NBJ, Daughters, GT, Stinson, EB, Hansen, DE, Miller, DC.Alterations in left ventricular twist mechanics with inotropic stimulation and volume loading in human subjects. Circulation 1994; 89: 142–150.CrossRefGoogle ScholarPubMed
Schubert, U, Müller, M, Abdul-Khaliq, H, Norman, M.Preterm birth is associated with altered myocardial function in infancy. J Am Soc Echocardiogr 2016; 29: 670–678.CrossRefGoogle ScholarPubMed
Nasu, Y, Oyama, K, Nakano, S, et al.Longitudinal systolic strain of the bilayered ventricular septum during the first 72 hours of life in preterm infants. J Echocardio 2015; 13: 90–99.CrossRefGoogle ScholarPubMed
de Waal, K, Phad, N, Lakkundi, A, Tan, P.Cardiac function after the immediate transitional period in very preterm infants using speckle tracking analysis. Pediatr Cardiol 2016; 37: 295–303.CrossRefGoogle ScholarPubMed
Hirose, A, Khoo, NS, Aziz, K, et al.Evolution of left ventricular function in the preterm infant. J Am Soc Echocardiogr 2015; 28: 302–308.CrossRefGoogle ScholarPubMed
Czernik, C, Rhode, S, Helfer, S, Schmalisch, G, Bührer, C, Schmitz, L.Development of left ventricular longitudinal speckle tracking echocardiography in very low birth weight infants with and without bronchopulmonary dysplasia during the neonatal period. PLoS One 2014; 9: e106504.CrossRefGoogle ScholarPubMed
Helfer, S, Schmitz, L, Bührer, C, Czernik, C.Tissue doppler-derived strain and strain rate during the first 28 days of life in very low birth weight infants. Echocardiography 2014; 31: 765–772.CrossRefGoogle ScholarPubMed
Greenbaum, RA, Ho, SY, Gibson, DG, Becker, AE, Anderson, RH.Left ventricular fiber architecture in man. Br Heart J 1981; 45: 248–263.CrossRefGoogle Scholar
Streeter, DDJ, Spotnitz, HM, Patel, DP, Ross, JJ, Sonnenblick, EH.Fiber orientation in the canine left ventricle during diastole and systole. Circ Res 1969; 24: 339–334.CrossRefGoogle ScholarPubMed
Bussmann, N, Smith, A, Cappelleri, A, et al.Circumferential and radial deformation assessment in premature infants: Ready for primetime? Echocardiography 2019; 36: 1532–1539.CrossRefGoogle ScholarPubMed
Leeson, P, Lewandowski, AJ.A new risk factor for early heart failure: preterm birth. J Am Coll Cardiol 2017; 69: 2643–2645.CrossRefGoogle ScholarPubMed
Al-Naami, GH.Torsion of young hearts: a speckle tracking study of normal infants, children, and adolescents. Eur J Echocardiogr 2010; 11: 853–862.CrossRefGoogle ScholarPubMed
Zhang, Y, Zhou, Q-c, Pu, D-r, Zou, L, Tan, Y. Differences in left ventricular twist related to age: speckle tracking echocardiographic data for healthy volunteers from neonate to age 70 years. Echocardiography 2010; 27: 1205–1210.CrossRefGoogle ScholarPubMed
Kim, HJ, Yoon, JH, Lee, EJ, et al.Normal left ventricular torsion mechanics in healthy children: age related changes of torsion parameters are closely related to changes in heart rate. Korean Circ J 2015; 45: 131–140.CrossRefGoogle ScholarPubMed
Buckberg, G, Hoffman, JIE, Mahajan, A, Saleh, S, Coghlan, C.Cardiac mechanics revisited: the relationship of cardiac architecture to ventricular function. Circulation 2008; 118: 2571–2587.CrossRefGoogle ScholarPubMed
Dong, SJ, Hees, PS, Huang, WM, Buffer, SAJ, Weiss, JL, Shapiro, EP.Independent effects of preload, afterload, and contractility on left ventricular torsion. Am J Physiol 1999; 277: H1053–H1060.Google ScholarPubMed
Raju, TNK, Buist, AS, Blaisdell, CJ, Moxey-Mims, M, Saigal, S.Adults born preterm: a review of general health and specific outcomes. Acta Paediatr 2017; 106: 1409–1437.CrossRefGoogle ScholarPubMed
Lewandowski, AJ, Augustine, D, Lamata, P, et al.Preterm heart in adult life: cardiovascular magnetic resonance reveals distinct differences in left ventricular mass, geometry, and function. Circulation 2013; 127: 197–206.CrossRefGoogle ScholarPubMed
Supplementary material: File

Lehmann et al. Supplementary materials

Lehmann et al. Supplementary materials

Download Lehmann et al. Supplementary materials(File)
File 15.9 KB