Decreased early diastolic function after indomethacin administration in premature infants.
The effect of indomethacin on systolic and diastolic cardiac function was assessed in 15 premature infants. Seven infants (group 1) received indomethacin to treat a clinically significant patent ductus arteriosus (PDA), and eight infants (group 2) received indomethacin prophylactically at 24 hours of age because of their high risk for PDA. Diastolic cardiac function was assessed using instantaneous rates of change of left ventricular (LV) cavity dimension, derived from M-mode echocardiography. The maximum velocity of lengthening of the LV cavity dimension, an index of early diastolic function, fell from 63 +/- 19 mm/sec before indomethacin to 48 +/- 16 mm/sec 1 hour after indomethacin in group 1 (P less than 0.01), with the ductus still patent and the LV chamber still dilated, and also decreased in group 2, from 52 +/- 7 mm/sec to 38 +/- 6 mm/sec (P less than 0.01). This index, when normalized for loading conditions, was decreased 1 hour after indomethacin at 12 +/- 2 sec-1 and 12 +/- 1 sec-1 for groups 1 and 2, respectively, compared with values before indomethacin of 15 +/- 3 sec-1 and 15 +/- 2 sec-1. There was no effect of indomethacin on the indices of systolic function. We conclude that indomethacin decreases early diastolic function in premature infants.
Appleton
R S
RS
Department of Pediatrics, Vanderbilt Medical University, Nashville, Tennessee.
Graham
T P
TP
Cotton
R B
RB
Moreau
G A
GA
Boucek
R J
RJ
D003971:Diastole / Q000187:drug effects*; D004374:Ductus Arteriosus, Patent / Q000188:drug therapy* / Q000517:prevention & control; D004452:Echocardiography; D006801:Humans; D007213:Indomethacin / Q000627:therapeutic use*; D007231:Infant, Newborn; D007234:Infant, Premature; D009200:Myocardial Contraction / Q000187:drug effects*; D013599:Systole / Q000187:drug effects
D007213:Indomethacin