96 Long-term cardiac outcomes in children with congenital diaphragmatic hernia: A prospective echocardiographic study

Background Congenital diaphragmatic hernia (CDH) involves lung hypoplasia, pulmonary hypertension, and left ventricular (LV) hypoplasia. Although research has focused on neonatal outcomes, long-term cardiac function in CDH patients remains unclear. This study explores whether children with CDH have persistent LV hypoplasia, altered cardiac function, and increased pulmonary pressures at follow-up. Objectives Assess LV dimensions, pulmonary arterial (PA) pressure and cardiac function by echocardiography in children with CDH. Design/Methods This prospective observational pilot study enrolled paediatric CDH patients from the multidisciplinary CDH clinic at Montreal Children’s Hospital, with assessments at 5, 10, and 45 months. Research echocardiograms (ECHO) were conducted by the NeoCardioLab team to evaluate LV and RV function, dimensions, and pulmonary pressures. Data was analyzed offline by a blinded expert. Descriptive statistics were performed by age group, and the latest ECHO results compared patients based on the presence or absence of liver in the chest, a marker of disease severity. Results A total of 23 ECHO were performed, with 7 participants contributing to more than one time point. Conventional ECHO metrics, outlined in Table 1 by age group, were within normal ranges for pulmonary artery pressures, RV/LV function, and dimensions (mass and diameters). The latest ECHO of 16 participants (7 with liver in the chest, 9 without) was analyzed. Patients with liver in the chest had significantly smaller LV diastolic and systolic diameters on M-mode (p<0.05). Otherwise, PA pressure, cardiac function, and dimensions were similar between groups. Conclusion Children with CDH, particularly those with liver in the chest, show signs of reduced LV dimensions. However, most conventional metrics of cardiac function and dimensions remained within normal limits up to 45 months of follow-up. Our future steps will focus on assessing cardiac strain and extending the evaluation to additional age groups, including patients up to 18 years old.