title: Global myocardial function is compromised in infants with pulmonary hypertension.
abstract: OBJECTIVE
  Persistent pulmonary hypertension of the newborn is a serious clinical entity with significant mortality and long-term morbidity. The objective was to study the profile of myocardial function, especially diastolic function, in term infants with pulmonary hypertension treated with nitric oxide.
  
  
  METHODS
  Unit electronic database was accessed to identify infants ≥34 weeks gestation who were administered nitric oxide for pulmonary hypertension over the last 6 years. Medical records and archived echocardiographic images were retrieved. Those with no echocardiogram on the day of administration of nitric oxide, concomitant congenital heart disease or ≥2 weeks of age at the time of nitric administration were excluded.
  
  
  RESULTS
  Low biventricular outputs were noted in >2/3rd infants. Tricuspid regurgitation was noted in 20/25 (80%) infants, and ductal shunt was bidirectional in the majority of cases. Right ventricular diastolic function was assessed by systolic to diastolic duration ratio; dysfunction was widely prevalent.
  
  
  CONCLUSIONS
  A large percentage of infants were haemodynamically severely compromised. This is the first study to detail right ventricular diastolic dysfunction in infants with pulmonary hypertension and highlights the therapeutic role of milrinone, a lusitropic drug with myocardial relaxation properties. Comprehensive evaluation of cardiovascular haemodynamics can optimize clinical care.
authors.affiliation: Monash Newborn, Monash Medical Centre, Melbourne, Australia. arvind.sehgal@southernhealth.org.au
authors.forename: Arvind
authors.initials: A
authors.lastname: Sehgal
authors.forename: Sam E
authors.initials: SE
authors.lastname: Athikarisamy
authors.forename: Maria
authors.initials: M
authors.lastname: Adamopoulos
mesh_terms: D003971:Diastole / Q000502:physiology*; D004452:Echocardiography; D006321:Heart / Q000502:physiology*; D006801:Humans; D006976:Hypertension, Pulmonary / Q000188:drug therapy / Q000503:physiopathology*; D007231:Infant, Newborn; D009569:Nitric Oxide / Q000627:therapeutic use; D012189:Retrospective Studies; D016896:Treatment Outcome; D014665:Vasodilator Agents / Q000627:therapeutic use
chemical_list: D014665:Vasodilator Agents; D009569:Nitric Oxide