title: Echocardiogram done early in neonatal sepsis:  what does it add?
abstract: BACKGROUND
  One of the major organs affected in neonatal sepsis is the heart. Echocardiogram provides real-time information on the cardiovascular performance rather than dependence on the clinical signs alone, which might lead to misjudgment.
  
  
  OBJECTIVE
  To assess left ventricular (LV) functions in septic neonates early after admission using transthoracic color Doppler Echocardiography.
  
  
  METHODS
  Echocardiography was done to 30 septic and 30 nonseptic newborns who were divided among 4 groups (septic full-term, 14; septic preterm, 16; nonseptic full-term, 21; and nonseptic preterm, 9). Comparisons were made among the 4 groups using analysis of variance and post hoc test regarding the systolic function (using ejection fraction and fractional shortening), the diastolic function (using the early patrial peak/atrial peak flow velocity ratio), and the global LV function (using myocardial performance index).
  
  
  RESULTS
  The E-wave and the early peak flow velocity/atrial peak flow velocity ratio were significantly lower in the septic neonates, whether full-term or premature, compared to their corresponding age groups in the nonseptic newborns, suggesting LV diastolic dysfunction (P < 0.001 and P < 0.014, respectively). No difference was found in the diastolic function between the full-term and the preterm neonates whether lying within the septic group or in the nonseptic group. Myocardial performance index was significantly higher in the septic neonates who died than in the survivors (P < 0.001).
  
  
  CONCLUSIONS
  Neonatal sepsis is associated with LV diastolic dysfunction.
authors.affiliation: Neonatal Tertiary Care Unit, Cairo University Children's Hospital, Cairo, Egypt. raniatomerak@yahoo.com
authors.forename: Rania H
authors.initials: RH
authors.lastname: Tomerak
authors.forename: Ayman A
authors.initials: AA
authors.lastname: El-Badawy
authors.forename: Gehan
authors.initials: G
authors.lastname: Hussein
authors.forename: Nermin R M
authors.initials: NR
authors.lastname: Kamel
authors.forename: Abdel Rahman A
authors.initials: AR
authors.lastname: Razak
mesh_terms: D003430:Cross-Sectional Studies; D004452:Echocardiography / Q000379:methods; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D047928:Premature Birth / Q000000981:diagnostic imaging / Q000503:physiopathology; D018805:Sepsis / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000503:physiopathology; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000503:physiopathology; D016277:Ventricular Function, Left / Q000502:physiology