Purpose: Early diagnosis of impaired myocardial function and timely therapeutic hypothermia is vital among patients with Neonatal Encephalopathy (NE). Traditional markers of myocardial function (Left Ventricular Ejection Fraction (LV EF) & LV Fractional Shortening (LV FS) can be variably reduced. Speckle tracking echocardiography (STE) is a more sensitive marker for impairment but remains inadequately studied in this patient population.
Methods: A retrospective study of neonates who underwent therapeutic hypothermia (TH) for NE from 2009 to2020 were matched 1:1 with normal neonates with normal echocardiograms performed for indications other than NE. Matching was based on gestational age, birth weight, days of age, and sex. Left ventricular 4 Chamber (4Ch) strain, right ventricular 4 Chamber (RV 4Ch), and RV free wall strain (RV FWS) were measured offline using vendor independent strain software (TomTec, GMBH, Munich, Germany).
Results: Ninety pairs of NE patients and controls were studied. Compared to controls, RV 4Ch strain (-17.3 % vs. -19.6 %), RV FWS (-18.8 % vs. -21.9 %), and RV fractional area change (FAC) (35 % vs. 37 %) were lower in NE cases (all p < 0.001), while differences in LV 4Ch strain, LV EF, and LV FS did not reach statistical significance. Moderate/severe NE (72 %) was associated with lower LV 4Ch strain compared to mild NE (-22.2 %/-19.3 % vs. -25.4 %, p = 0.004). RV 4Ch strain (-14.9 % vs. -18.8 %, p = 0.020) and RV FAC (27 % vs. 36 %, p = 0.006) were lower in severe NE compared to mild NE. Lower LV 4Ch was associated with need for chest compressions (-18.5 % vs. -23.3 %), epinephrine at delivery (-19.3 % vs. -23.4 %), and decreased survival to discharge (-15.9 % vs. -22.7 %).
Conclusions: RV and LV strain mechanics are impaired in NE patients. Lower RV Strain and LV 4Ch strain were associated with need for increased medical support and decreased survival to discharge.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.earlhumdev.2024.106163 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Hemodynamic analysis of left ventricular unloading with Impella versus IABP during VA-ECMO.
Acta Bioeng Biomech
June 2024
1Department of Biomedical Engineering, Hefei University of Technology, Hefei, People's Republic of China.
: The utilization of intra-aortic balloon pump (IABP) and Impella has been suggested as means of left ventricular unloading in veno-arterial extracorporeal membrane oxygenation (VA-ECMO) patients. This study aimed to assess the local hemodynamic alterations in VA-ECMO patients through simulation analyses. : In this study, a 0D-3D multiscale model was developed, wherein resistance conditions were employed to define the flow-pressure relationship.
View Article and Find Full Text PDFThe European Registry for Patients with Mechanical Circulatory Support (EUROMACS) of the European Association for Cardio-Thoracic Surgery Fourth report: Focus on standardized outcome ratios.
Eur J Cardiothorac Surg
January 2025
Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum der Charité (DHZC), Berlin, Germany. DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany.
Objectives: This fourth report aimed to provide insights into patient characteristics, outcomes, and standardized outcome ratios of patients implanted with durable Mechanical Circulatory Support across participating centers in the European Registry for Patients with Mechanical Circulatory Support (EUROMACS) registry.
Methods: All registered patients receiving durable mechanical circulatory support up to August 2024 were included. Expected number of events were predicted using penalized logistic regression.
Left Atrial Remodeling and Function in Various Left Ventricular Hypertrophic Phenotypes.
Eur Heart J Cardiovasc Imaging
January 2025
Heart Institute. Department of Cardiology. Cardiovascular Imaging Unit. Hospital Universitari Germans Trias i Pujol, Barcelona, Spain.
Aims: How the underlying etiology and pathophysiology of left ventricular (LV) hypertrophy affects LA remodeling and function remains unexplored. The present study aims to investigate the influence of various hypertrophic phenotypes on LA remodeling and function.
Methods And Results: Patients with LV hypertrophy who underwent cardiac magnetic resonance (CMR) were compared to a control group.
A Novel Staging System of Cardiac Damage in Aortic Stenosis based on Multi-Chamber Myocardial Deformation.
Eur Heart J Cardiovasc Imaging
January 2025
Department of Cardiology, Istituto Auxologico Italiano, IRCCS, Milan, Italy.
Aims: This study evaluates whether multi-chamber myocardial deformation analysis using speckle tracking echocardiography (STE) can enhance validated current staging systems and improve risk stratification for patients with moderate-to-severe aortic stenosis (AS).
Methods And Results: We reanalyzed 2D, Doppler, and STE data obtained from two cohorts: derivation (654 patients, median age: 82 years; 51% men) and validation (237 patients, median age: 77 years; 55% men) with at least moderate AS (aortic valve area<1.5 cm2).
Minimally Invasive Puncture and Drainage Surgery for the Treatment of Thalamic Hemorrhage Guided by a 3D-printed Guide Plate.
J Craniofac Surg
January 2025
School of Medical Imaging, Hangzhou Medical College, Hangzhou, China.
Thalamic hemorrhage is a type of intracerebral hemorrhage with high disability and mortality rates. Because of its deep bleeding location, irregular shape of the hematoma, and compression of the third ventricle, it is not suitable for craniotomy. This paper reports a case of a 63-year-old male patient who sought medical attention for left-sided basal ganglia and thalamus hemorrhage that broke into the ventricles.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!