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Circumferential and radial deformation assessment in premature infants: Ready for primetime?
Author(s) -
Bussmann Neidin,
Smith Aisling,
Cappelleri Alessia,
Levy Phillip T.,
McCallion Naomi,
Franklin Orla,
ELKhuffash Afif
Publication year - 2019
Publication title -
echocardiography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.404
H-Index - 62
eISSN - 1540-8175
pISSN - 0742-2822
DOI - 10.1111/echo.14442
Subject(s) - reproducibility , medicine , coefficient of variation , population , strain rate , ductus arteriosus , radial stress , strain (injury) , cardiology , nuclear medicine , deformation (meteorology) , materials science , mathematics , composite material , statistics , environmental health
Background Speckle tracking echocardiography (STE) is a validated method to measure longitudinal deformation in premature infants, but there is a paucity of data on STE‐derived circumferential and radial strain in this population. We assessed the feasibility and reproducibility of circumferential and radial deformation measurements in premature infants. Methods In a prospective study of 40 premature infants (<29 weeks of gestation at birth), STE‐derived circumferential and radial strain, systolic strain rate (SRs), early diastolic strain rate (SRe), and late diastolic strain rate (SRa) were measured on day 2 and day 8. Intra‐ and inter‐observer reproducibility analysis were performed using Bland–Altman analysis, coefficient of variation (COV), and intra‐class correlation coefficient (ICC). The impact of a persistent patent ductus arteriosus (PDA) was analyzed. Results Deformation analysis was feasible in 98% of the acquisitions. Circumferential parameters demonstrated excellent intra‐ and inter‐observer reproducibility with an ICC between 0.89 and 0.99 (all P < 0.001) and a COV between 4% and 13%. Radial parameters demonstrated acceptable intra‐ and inter‐observer reproducibility with an ICC between 0.73 and 0.96 (all P < 0.001) and a COV between 14% and 27%. Infants with a PDA on day 8 (n = 21, 53%) demonstrated higher radial strain, SRs and SRe. There were no differences in circumferential parameters with a PDA at either time point. Conclusion This study demonstrates clinical feasibility and reproducibility of circumferential and radial strain by STE in premature infants. A PDA elevates radial deformation measures, suggesting that the increased LV preload from a PDA may augment intrinsic contractility in the radial but not circumferential plane.