title: Cardiovascular magnetic resonance of cardiac function and myocardial mass in preterm infants: a preliminary study of the impact of patent ductus arteriosus.
abstract: BACKGROUND
  Many pathologies seen in the preterm population are associated with abnormal blood supply, yet robust evaluation of preterm cardiac function is scarce and consequently normative ranges in this population are limited. The aim of this study was to quantify and validate left ventricular dimension and function in preterm infants using cardiovascular magnetic resonance (CMR). An initial investigation of the impact of the common congenital defect patent ductus arteriosus (PDA) was then carried out.
  
  
  METHODS
  Steady State Free Procession short axis stacks were acquired. Normative ranges of left ventricular end diastolic volume (EDV), stroke volume (SV), left ventricular output (LVO), ejection fraction (EF), left ventricular (LV) mass, wall thickness and fractional thickening were determined in "healthy" (control) neonates. Left ventricular parameters were then investigated in PDA infants. Unpaired student t-tests compared the 2 groups. Multiple linear regression analysis assessed impact of shunt volume in PDA infants, p-value ≤ 0.05 being significant.
  
  
  RESULTS
  29 control infants median (range) corrected gestational age at scan 34+6(31+1-39+3) weeks were scanned. EDV, SV, LVO, LV mass normalized by weight and EF were shown to decrease with increasing corrected gestational age (cGA) in controls. In 16 PDA infants (cGA 30+3(27+3-36+1) weeks) left ventricular dimension and output were significantly increased, yet there was no significant difference in ejection fraction and fractional thickening between the two groups. A significant association between shunt volume and increased left ventricular mass correcting for postnatal age and corrected gestational age existed.
  
  
  CONCLUSIONS
  CMR assessment of left ventricular function has been validated in neonates, providing more robust normative ranges of left ventricular dimension and function in this population. Initial investigation of PDA infants would suggest that function is relatively maintained.
authors.forename: Kathryn M
authors.initials: KM
authors.lastname: Broadhouse
authors.forename: Anna E
authors.initials: AE
authors.lastname: Finnemore
authors.forename: Anthony N
authors.initials: AN
authors.lastname: Price
authors.forename: Giuliana
authors.initials: G
authors.lastname: Durighel
authors.forename: David J
authors.initials: DJ
authors.lastname: Cox
authors.forename: Anthony David
authors.initials: AD
authors.lastname: Edwards
authors.forename: Joseph V
authors.initials: JV
authors.lastname: Hajnal
authors.forename: Alan M
authors.initials: AM
authors.lastname: Groves
mesh_terms: D016022:Case-Control Studies; D004373:Ductus Arteriosus / Q000000981:diagnostic imaging / Q000473:pathology*; D004374:Ductus Arteriosus, Patent / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology; D018618:Echocardiography, Doppler, Color; D005865:Gestational Age; D006352:Heart Ventricles / Q000473:pathology* / Q000503:physiopathology*; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D007231:Infant, Newborn; D007234:Infant, Premature; D016014:Linear Models; D008279:Magnetic Resonance Imaging; D008955:Models, Cardiovascular; D009206:Myocardium / Q000473:pathology*; D015588:Observer Variation; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D013318:Stroke Volume; D016277:Ventricular Function, Left