Longitudinal follow-up of ventricular performance in healthy neonates.
BACKGROUND
Specific follow-up of newly introduced echocardiographic parameters in healthy neonates and infants is limited.


OBJECTIVE
To prospectively describe follow-up of left ventricular (LV) tissue Doppler imaging (TDI) and speckle tracking strain parameters in healthy subjects up to two months after birth.


METHODS
This is a longitudinal follow-up study.


METHODS
Twenty-eight (10 male) healthy newborns were included and underwent transthoracic echocardiography 1-3 days, 3 weeks and 6-7 weeks after birth.


METHODS
In each echocardiogram, parameters describing cardiac growth, including LV mass (LVM), were assessed. Additionally, TDI derived peak systolic velocity (S') and peak early (E') and late (A') diastolic velocities were assessed in the basal LV free wall and interventricular septum (IVS). Finally LV longitudinal, radial and circumferential global peak strain parameters were assessed using speckle tracking strain imaging.


RESULTS
LVM significantly increased during follow-up (7.6 ± 2.4 versus 12.4 ± 3.2g, p = 0.002). Similarly at 1-3 days versus 6-7 weeks after birth, an increase in LV and IVS systolic (LV S' 4.1 ± 1.5 versus 6.3 ± 1.5 cm/s, p = 0.001; IVS S' 3.6 ± 0.9 versus 6.4 ± 1.3 cm/s, p < 0.001) and diastolic (LV E' 6.1 ± 2.2 versus 9.7 ± 2.9 cm/s, p = 0.002; IVS E' 5.1 ± 1.4 versus 10.7 ± 3.3 cm/s, p < 0.001) TDI parameters was observed. In contrast, global peak longitudinal, radial and circumferential strain parameters did not significantly change during follow-up.


CONCLUSIONS
A significant increase in LV systolic and diastolic TDI parameters was observed up to two months after birth. Yet this increase may be (cardiac) growth-dependent. No significant changes were observed in speckle tracking strain derived global peak strain parameters; this may render the technique particularly valuable in evaluation of LV systolic performance during periods of significant growth, such as the neonatal period.
Department of Pediatric Cardiology, Leiden University Medical Center, PO Box 9600, Room J6S-208, 2300RC Leiden, The Netherlands.
Liselotte M
LM
Klitsie
Arno A W
AA
Roest
Monique C
MC
Haak
Nico A
NA
Blom
Arend D J
AD
Ten Harkel
D004452:Echocardiography / Q000379:methods / Q000706:statistics & numerical data*; D005500:Follow-Up Studies; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D018709:Statistics, Nonparametric; D018617:Ultrasonography, Doppler, Pulsed; D016276:Ventricular Function / Q000502:physiology*
Echocardiography; Infant; Newborn; Speckle tracking strain imaging; Tissue Doppler imaging