Maturational patterns of left ventricular rotational mechanics in pre-term infants through 1 year of age

Cardiol Young. 2020 Sep;30(9):1238-1246. doi: 10.1017/S1047951120001912. Epub 2020 Jul 15.

Abstract

Background: Pre-mature birth impacts left ventricular development, predisposing this population to long-term cardiovascular risk. The aims of this study were to investigate maturational changes in rotational properties from the neonatal period through 1 year of age and to discern the impact of cardiopulmonary complications of pre-maturity on these measures.

Methods: Pre-term infants (<29 weeks at birth, n = 117) were prospectively enrolled and followed to 1-year corrected age. Left ventricular basal and apical rotation, twist, and torsion were measured by two-dimensional speckle-tracking echocardiography and analysed at 32 and 36 weeks post-menstrual age and 1-year corrected age. A mixed random effects model with repeated measures analysis was used to compare rotational mechanics over time. Torsion was compared in infants with and without complications of cardiopulmonary diseases of pre-maturity, specifically bronchopulmonary dysplasia, pulmonary hypertension, and patent ductus arteriosus.

Results: Torsion decreased from 32 weeks post-menstrual age to 1-year corrected age in all pre-term infants (p < 0.001). The decline from 32 to 36 weeks post-menstrual age was more pronounced in infants with cardiopulmonary complications, but was similar to healthy pre-term infants from 36 weeks post-menstrual age to 1-year corrected age. The decline was due to directional and magnitude changes in apical rotation over time (p < 0.05).

Conclusion: This study tracks maturational patterns of rotational mechanics in pre-term infants and reveals torsion declines from the neonatal period through 1 year. Cardiopulmonary diseases of pre-maturity may negatively impact rotational mechanics during the neonatal period, but the myocardium recovers by 1-year corrected age.

Keywords: Cardiac function; pre-maturity; rotational strain; torsion.

MeSH terms

  • Bronchopulmonary Dysplasia* / diagnostic imaging
  • Ductus Arteriosus, Patent* / diagnostic imaging
  • Echocardiography
  • Heart Ventricles* / diagnostic imaging
  • Humans
  • Hypertension, Pulmonary*
  • Infant
  • Infant, Newborn
  • Ventricular Function, Left