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Biventricular function on early echocardiograms in neonatal hypoxic–ischaemic encephalopathy
Author(s) -
Aggarwal Sanjeev,
Natarajan Girija
Publication year - 2017
Publication title -
acta paediatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/apa.13866
Subject(s) - medicine , encephalopathy , cardiology , diastole , shunt (medical) , ventricular function , hypothermia , pediatrics , blood pressure
Aim To compare early (<24 hours) echocardiograms ( ECHO s) in infants with perinatal hypoxic–ischaemic encephalopathy ( HIE ) undergoing (i) therapeutic hypothermia ( TH ), (ii) normothermia and (iii) normal controls. Methods This was a single‐centre retrospective review of clinical early ECHO s of term infants with moderate or severe HIE and controls (with a normal ECHO <72 hours of age). Right ( RVO ) and left ventricular output ( LVO ), RV and LV myocardial performance index ( MPI ), systolic to diastolic duration ratio (S/D) and eccentricity indices ( EI ) in systole and diastole were compared using ANOVA . Results Among infants with HIE (n = 56, 38 in the TH and 18 in normothermia groups), 14 (25%) infants died and 42 survived. Significantly elevated biventricular MPI , lower RVO and LVO and pulmonary hypertension (abnormal EI , higher RV S/D and bidirectional or right‐to‐left ductal shunt) were found in groups with HIE , compared to controls (n = 35). LV MPI was lower in HIE ‐ TH , compared to the HIE ‐normothermia group. Infants with HIE who died (n = 14) had a significantly lower EI d [0.77 (0.09) vs. 0.83 (0.08), p = 0.021] compared to survivors (n = 42). Conclusion Infants with perinatal HIE have ventricular dysfunction; those who died had significantly lower EI d than survivors; this association needs to be further validated.