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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*
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
*Corresponding
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

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.

Type
Original Article
Copyright
© The Author(s), 2020. Published by Cambridge University Press

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