Maturational Patterns of Systolic Ventricular Deformation Mechanics by Two-Dimensional Speckle-Tracking Echocardiography in Preterm Infants over the First Year of Age

Philip T. Levy; Afif EL-Khuffash; Meghna D. Patel; Colm R. Breatnach; Adam T. James; Aura A. Sanchez; Cristina Abuchabe; Sarah R. Rogal; Mark R. Holland; Patrick J. McNamara; Amish Jain; Orla Franklin; Luc Mertens; Aaron Hamvas; Gautam K. Singh

doi:10.1016/j.echo.2017.03.003

Maturational Patterns of Systolic Ventricular Deformation Mechanics by Two-Dimensional Speckle-Tracking Echocardiography in Preterm Infants over the First Year of Age

Philip T. Levy, Afif EL-Khuffash, Meghna D. Patel, Colm R. Breatnach, Adam T. James, Aura A. Sanchez, Cristina Abuchabe, Sarah R. Rogal, Mark R. Holland, Patrick J. McNamara, Amish Jain, Orla Franklin, Luc Mertens, Aaron Hamvas, Gautam K. Singh

Pediatrics - Administration

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Abstract

Background The aim of this study was to determine the maturational changes in systolic ventricular strain mechanics by two-dimensional speckle-tracking echocardiography in extremely preterm neonates from birth to 1 year of age and discern the impact of common cardiopulmonary abnormalities on the deformation measures. Methods In a prospective multicenter study of 239 extremely preterm infants (<29 weeks gestation at birth), left ventricular (LV) global longitudinal strain (GLS) and global longitudinal systolic strain rate (GLSRs), interventricular septal wall (IVS) GLS and GLSRs, right ventricular (RV) free wall longitudinal strain and strain rate, and segmental longitudinal strain in the RV free wall, LV free wall, and IVS were serially measured on days 1, 2, and 5 to 7, at 32 and 36 weeks postmenstrual age, and at 1 year corrected age (CA). Premature infants who developed bronchopulmonary dysplasia or had echocardiographic findings of pulmonary hypertension were analyzed separately. Results In uncomplicated preterm infants (n = 103 [48%]), LV GLS and GLSRs remained unchanged from days 5 to 7 to 1 year CA (P =.60 and P =.59). RV free wall longitudinal strain, RV free wall longitudinal strain rate, and IVS GLS and GLSRs significantly increased over the same time period (P <.01 for all measures). A significant base-to-apex (highest to lowest) segmental longitudinal strain gradient (P <.01) was seen in the RV free wall and a reverse apex-to-base gradient (P <.01) in the LV free wall. In infants with bronchopulmonary dysplasia and/or pulmonary hypertension (n = 119 [51%]), RV free wall longitudinal strain and IVS GLS were significantly lower (P <.01), LV GLS and GLSRs were similar (P =.56), and IVS segmental longitudinal strain persisted as an RV-dominant base-to-apex gradient from 32 weeks postmenstrual age to 1 year CA. Conclusions This study tracks the maturational patterns of global and regional deformation by two-dimensional speckle-tracking echocardiography in extremely preterm infants from birth to 1 year CA. The maturational patterns are ventricular specific. Bronchopulmonary dysplasia and pulmonary hypertension leave a negative impact on RV and IVS strain, while LV strain remains stable.

Original language	English (US)
Pages (from-to)	685-698.e1
Journal	Journal of the American Society of Echocardiography
Volume	30
Issue number	7
DOIs	https://doi.org/10.1016/j.echo.2017.03.003
State	Published - Jul 2017

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Publisher Copyright:
© 2017 American Society of Echocardiography

Keywords

Cardiac function
Echocardiography
Prematurity
Strain imaging

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.echo.2017.03.003

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5495609

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Levy, P. T., EL-Khuffash, A., Patel, M. D., Breatnach, C. R., James, A. T., Sanchez, A. A., Abuchabe, C., Rogal, S. R., Holland, M. R., McNamara, P. J., Jain, A., Franklin, O., Mertens, L., Hamvas, A., & Singh, G. K. (2017). Maturational Patterns of Systolic Ventricular Deformation Mechanics by Two-Dimensional Speckle-Tracking Echocardiography in Preterm Infants over the First Year of Age. Journal of the American Society of Echocardiography, 30(7), 685-698.e1. https://doi.org/10.1016/j.echo.2017.03.003

Maturational Patterns of Systolic Ventricular Deformation Mechanics by Two-Dimensional Speckle-Tracking Echocardiography in Preterm Infants over the First Year of Age. / Levy, Philip T.; EL-Khuffash, Afif; Patel, Meghna D. et al.
In: Journal of the American Society of Echocardiography, Vol. 30, No. 7, 07.2017, p. 685-698.e1.

Research output: Contribution to journal › Article › peer-review

Levy, PT, EL-Khuffash, A, Patel, MD, Breatnach, CR, James, AT, Sanchez, AA, Abuchabe, C, Rogal, SR, Holland, MR, McNamara, PJ, Jain, A, Franklin, O, Mertens, L, Hamvas, A & Singh, GK 2017, 'Maturational Patterns of Systolic Ventricular Deformation Mechanics by Two-Dimensional Speckle-Tracking Echocardiography in Preterm Infants over the First Year of Age', Journal of the American Society of Echocardiography, vol. 30, no. 7, pp. 685-698.e1. https://doi.org/10.1016/j.echo.2017.03.003

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title = "Maturational Patterns of Systolic Ventricular Deformation Mechanics by Two-Dimensional Speckle-Tracking Echocardiography in Preterm Infants over the First Year of Age",

abstract = "Background The aim of this study was to determine the maturational changes in systolic ventricular strain mechanics by two-dimensional speckle-tracking echocardiography in extremely preterm neonates from birth to 1 year of age and discern the impact of common cardiopulmonary abnormalities on the deformation measures. Methods In a prospective multicenter study of 239 extremely preterm infants (<29 weeks gestation at birth), left ventricular (LV) global longitudinal strain (GLS) and global longitudinal systolic strain rate (GLSRs), interventricular septal wall (IVS) GLS and GLSRs, right ventricular (RV) free wall longitudinal strain and strain rate, and segmental longitudinal strain in the RV free wall, LV free wall, and IVS were serially measured on days 1, 2, and 5 to 7, at 32 and 36 weeks postmenstrual age, and at 1 year corrected age (CA). Premature infants who developed bronchopulmonary dysplasia or had echocardiographic findings of pulmonary hypertension were analyzed separately. Results In uncomplicated preterm infants (n = 103 [48%]), LV GLS and GLSRs remained unchanged from days 5 to 7 to 1 year CA (P =.60 and P =.59). RV free wall longitudinal strain, RV free wall longitudinal strain rate, and IVS GLS and GLSRs significantly increased over the same time period (P <.01 for all measures). A significant base-to-apex (highest to lowest) segmental longitudinal strain gradient (P <.01) was seen in the RV free wall and a reverse apex-to-base gradient (P <.01) in the LV free wall. In infants with bronchopulmonary dysplasia and/or pulmonary hypertension (n = 119 [51%]), RV free wall longitudinal strain and IVS GLS were significantly lower (P <.01), LV GLS and GLSRs were similar (P =.56), and IVS segmental longitudinal strain persisted as an RV-dominant base-to-apex gradient from 32 weeks postmenstrual age to 1 year CA. Conclusions This study tracks the maturational patterns of global and regional deformation by two-dimensional speckle-tracking echocardiography in extremely preterm infants from birth to 1 year CA. The maturational patterns are ventricular specific. Bronchopulmonary dysplasia and pulmonary hypertension leave a negative impact on RV and IVS strain, while LV strain remains stable.",

keywords = "Cardiac function, Echocardiography, Prematurity, Strain imaging",

author = "Levy, {Philip T.} and Afif EL-Khuffash and Patel, {Meghna D.} and Breatnach, {Colm R.} and James, {Adam T.} and Sanchez, {Aura A.} and Cristina Abuchabe and Rogal, {Sarah R.} and Holland, {Mark R.} and McNamara, {Patrick J.} and Amish Jain and Orla Franklin and Luc Mertens and Aaron Hamvas and Singh, {Gautam K.}",

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year = "2017",

month = jul,

doi = "10.1016/j.echo.2017.03.003",

language = "English (US)",

volume = "30",

pages = "685--698.e1",

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T1 - Maturational Patterns of Systolic Ventricular Deformation Mechanics by Two-Dimensional Speckle-Tracking Echocardiography in Preterm Infants over the First Year of Age

AU - Levy, Philip T.

AU - EL-Khuffash, Afif

AU - Patel, Meghna D.

AU - Breatnach, Colm R.

AU - James, Adam T.

AU - Sanchez, Aura A.

AU - Abuchabe, Cristina

AU - Rogal, Sarah R.

AU - Holland, Mark R.

AU - McNamara, Patrick J.

AU - Jain, Amish

AU - Franklin, Orla

AU - Mertens, Luc

AU - Hamvas, Aaron

AU - Singh, Gautam K.

PY - 2017/7

Y1 - 2017/7

N2 - Background The aim of this study was to determine the maturational changes in systolic ventricular strain mechanics by two-dimensional speckle-tracking echocardiography in extremely preterm neonates from birth to 1 year of age and discern the impact of common cardiopulmonary abnormalities on the deformation measures. Methods In a prospective multicenter study of 239 extremely preterm infants (<29 weeks gestation at birth), left ventricular (LV) global longitudinal strain (GLS) and global longitudinal systolic strain rate (GLSRs), interventricular septal wall (IVS) GLS and GLSRs, right ventricular (RV) free wall longitudinal strain and strain rate, and segmental longitudinal strain in the RV free wall, LV free wall, and IVS were serially measured on days 1, 2, and 5 to 7, at 32 and 36 weeks postmenstrual age, and at 1 year corrected age (CA). Premature infants who developed bronchopulmonary dysplasia or had echocardiographic findings of pulmonary hypertension were analyzed separately. Results In uncomplicated preterm infants (n = 103 [48%]), LV GLS and GLSRs remained unchanged from days 5 to 7 to 1 year CA (P =.60 and P =.59). RV free wall longitudinal strain, RV free wall longitudinal strain rate, and IVS GLS and GLSRs significantly increased over the same time period (P <.01 for all measures). A significant base-to-apex (highest to lowest) segmental longitudinal strain gradient (P <.01) was seen in the RV free wall and a reverse apex-to-base gradient (P <.01) in the LV free wall. In infants with bronchopulmonary dysplasia and/or pulmonary hypertension (n = 119 [51%]), RV free wall longitudinal strain and IVS GLS were significantly lower (P <.01), LV GLS and GLSRs were similar (P =.56), and IVS segmental longitudinal strain persisted as an RV-dominant base-to-apex gradient from 32 weeks postmenstrual age to 1 year CA. Conclusions This study tracks the maturational patterns of global and regional deformation by two-dimensional speckle-tracking echocardiography in extremely preterm infants from birth to 1 year CA. The maturational patterns are ventricular specific. Bronchopulmonary dysplasia and pulmonary hypertension leave a negative impact on RV and IVS strain, while LV strain remains stable.

AB - Background The aim of this study was to determine the maturational changes in systolic ventricular strain mechanics by two-dimensional speckle-tracking echocardiography in extremely preterm neonates from birth to 1 year of age and discern the impact of common cardiopulmonary abnormalities on the deformation measures. Methods In a prospective multicenter study of 239 extremely preterm infants (<29 weeks gestation at birth), left ventricular (LV) global longitudinal strain (GLS) and global longitudinal systolic strain rate (GLSRs), interventricular septal wall (IVS) GLS and GLSRs, right ventricular (RV) free wall longitudinal strain and strain rate, and segmental longitudinal strain in the RV free wall, LV free wall, and IVS were serially measured on days 1, 2, and 5 to 7, at 32 and 36 weeks postmenstrual age, and at 1 year corrected age (CA). Premature infants who developed bronchopulmonary dysplasia or had echocardiographic findings of pulmonary hypertension were analyzed separately. Results In uncomplicated preterm infants (n = 103 [48%]), LV GLS and GLSRs remained unchanged from days 5 to 7 to 1 year CA (P =.60 and P =.59). RV free wall longitudinal strain, RV free wall longitudinal strain rate, and IVS GLS and GLSRs significantly increased over the same time period (P <.01 for all measures). A significant base-to-apex (highest to lowest) segmental longitudinal strain gradient (P <.01) was seen in the RV free wall and a reverse apex-to-base gradient (P <.01) in the LV free wall. In infants with bronchopulmonary dysplasia and/or pulmonary hypertension (n = 119 [51%]), RV free wall longitudinal strain and IVS GLS were significantly lower (P <.01), LV GLS and GLSRs were similar (P =.56), and IVS segmental longitudinal strain persisted as an RV-dominant base-to-apex gradient from 32 weeks postmenstrual age to 1 year CA. Conclusions This study tracks the maturational patterns of global and regional deformation by two-dimensional speckle-tracking echocardiography in extremely preterm infants from birth to 1 year CA. The maturational patterns are ventricular specific. Bronchopulmonary dysplasia and pulmonary hypertension leave a negative impact on RV and IVS strain, while LV strain remains stable.

KW - Cardiac function

KW - Echocardiography

KW - Prematurity

KW - Strain imaging

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Maturational Patterns of Systolic Ventricular Deformation Mechanics by Two-Dimensional Speckle-Tracking Echocardiography in Preterm Infants over the First Year of Age

Abstract

Bibliographical note

Keywords

UN SDGs

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