High frame rate echocardiography with blood speckle tracking in stable preterm infants revealed that diastolic energy loss to kinetic energy ratio increased from 4.9% to 9.2% during neonatal admission.
Observational (n=55)
High frame rate echocardiography with blood speckle tracking reveals that stable preterm infants have relatively poor cardiac inflow efficiency due to high energy loss during diastole.
Background The typical intracardiac blood flow pattern of a healthy left ventricle includes vortex formations to help store energy, facilitate valve closure and propagation of blood flow toward the outflow tract. Intracardiac blood flow patterns can be visualised with high frame rate echocardiography with blood speckle tracking (BST) and analysed for measures of cardiac efficiency such as kinetic energy (KE), energy loss (EL), vorticity (VO) and vortex complexity (VC). Preterm infants are at high risk of cardiac compromise, but mechanistic pathways are unclear. The aim of this study is to gather BST reference values in stable preterm infants. Methods Stable low risk preterm infants < 30 weeks gestation underwent echocardiography with BST early and late in the neonatal admission period. PyUSview software was used for intracardiac flow analysis. Results 55 stable preterm infants we included. KE, EL, VO and VC were significantly higher in diastole when compared to systole and most BST parameters increased during the admission period. EL/KE as measure of cardiac efficiency remained stable around 3% during systole, but EL/KE during diastole increased from 4.9 to 9.2% along with increasing E and A velocities, which is higher than reported in healthy term infants. Conclusion Reference ranges of BST intracardiac flow parameters in stable low risk preterm infants suggest relatively poor cardiac inflow efficiency due to high EL. This data can assist in the development of further clinical applications for BST in preterm infants, such as predicting disease progression, monitoring treatments and early diagnosis of adverse LV remodeling.
Waal et al. (2026) conducted an observational in Stable low risk preterm infants (n=55). High frame rate echocardiography with blood speckle tracking (BST) was evaluated on Intracardiac flow parameters (kinetic energy, energy loss, vorticity, vortex complexity). High frame rate echocardiography with blood speckle tracking in stable preterm infants revealed that diastolic energy loss to kinetic energy ratio increased from 4.9% to 9.2% during neonatal admission.