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Myocardial function in late preterm infants during the transitional period: comprehensive appraisal with deformation mechanics and non-invasive cardiac output monitoring

  • Alessia Cappelleri (a1) (a2), Neidin Bussmann (a1), Susan Harvey (a1), Phillip T. Levy (a3), Orla Franklin (a4) and Afif EL-Khuffash (a1) (a5)...

Abstract

Background:

There is a paucity of functional data on mid-to-late preterm infants between 30+0 and 34+6 weeks gestation. We aimed to characterise transitional cardiopulmonary and haemodynamic changes during the first 48 hours in asymptomatic mid-to-late preterm infants.

Methods:

Forty-five healthy preterm newborns (mean ± standard deviation) gestation of 32.7 ± 1.2 weeks) underwent echocardiography on Days 1 and 2. Ventricular mechanics were assessed by speckle tracking-derived deformation, rotational mechanics, tissue Doppler imaging, and right ventricle-focused measures (tricuspid annular plane systolic excursion, fractional area change). Continuous haemodynamics were assessed using the NICOM™ system to obtain left ventricular output, stroke volume, heart rate, and total peripheral resistance by non-invasive cardiac output monitoring.

Results:

Right ventricular function increased (all measures p < 0.005) with mostly stable left ventricular performance between Day 1 and Day 2. NICOM-derived left ventricular output [mean 34%, 95% confidence interval 21–47%] and stroke volume [29%, 16–42%] increased with no change in heart rate [5%, −2 to 12%]. There was a rise in mean blood pressure [11%, 1–21%], but a decline in total peripheral resistance [−14%, −25 to −3%].

Conclusion:

Left ventricular mechanics remained persevered in mid-to-late premature infants, but right ventricular function increased. Non-invasive cardiac output monitoring is feasible in preterm infants with an increase in left ventricular output driven by an improvement in stroke volume during the transitional period.

Copyright

Corresponding author

Author for correspondence: A. EL-Khuffash, FRCPI, MD, DCE, Consultant Neonatologist, Clinical Professor of Paediatrics, The Rotunda Hospital, Royal College of Surgeons in Ireland, Dublin, Ireland. Tel: + 353 1 817 1700; E-mail: afifelkhuffash@rcsi.ie

References

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Myocardial function in late preterm infants during the transitional period: comprehensive appraisal with deformation mechanics and non-invasive cardiac output monitoring

  • Alessia Cappelleri (a1) (a2), Neidin Bussmann (a1), Susan Harvey (a1), Phillip T. Levy (a3), Orla Franklin (a4) and Afif EL-Khuffash (a1) (a5)...

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