Key result
Preterm neonates at 40 weeks of postconceptional age demonstrated preserved left ventricular function, with a significantly lower myocardial performance index compared to term neonates after PDA closure (0.31 vs 0.39, p<0.001).
Why the study?
Gestational and chronological age may influence immature myocardium, but the transition from fetal to neonatal circulation in preterm neonates is poorly understood.
Does left ventricular function differ between preterm neonates at 40 weeks postconceptional age and term neonates?
Cross-Sectional (n=118)
No
Does left ventricular function differ between preterm neonates at 40 weeks postconceptional age and term neonates?
Absolute Event Rate: 0.31% vs 0.39%
p-value: p=<0.001
Preterm neonates at 40 weeks postconceptional age demonstrate preserved left ventricular systolic and diastolic function comparable to term neonates, suggesting adequate functional adaptation of the immature myocardium.
Supports preserved LV function in preterm neonates at term-corrected age; leaves open optimal comparison timing and long-term clinical relevance.
BACKGROUND Both gestational and chronological age of the neonate may influence and impair the function of the delicate and immature myocardium. However, the transition from fetal to neonatal circulation in preterm neonates is poorly understood. AIMS This study aimed to compare left ventricular (LV) systolic and diastolic function between premature neonates at expected term and term neonates during the postnatal cardiovascular transitional period. METHODS Using echocardiography, we assessed systolic and diastolic function of the LV in 89 preterm neonates at week 40 of postconceptional age and 29 term neonates after closure of the patent ductus arteriosus (PDA) and on the 28th day of life. Based on M‑mode images, we measured myocardial thickness and fractional shortening (FS%). Using pulsed‑wave Doppler echocardiography, we estimated cardiac output, myocardial performance index (MPI), and LV diastolic function (E and A waves, E/A ratio). Systolic and diastolic function was also assessed by tissue Doppler imaging. RESULTS Compared with term neonates on the 28th day of life, preterm neonates had reduced myocardial thickness (P ≤0.04), FS% (P = 0.002), and cardiac output (P = 0.01). However, preterm neonates had a lower MPI than term neonates after PDA closure (P <0.001) and on the 28th day of life (P = 0.02). The E/A ratio and S' wave values were similar in preterm and term neonates (P >0.05). CONCLUSIONS Preterm neonates at 40 weeks of postconceptional age have preserved systolic and diastolic function of the LV.
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Bokiniec et al. (2019) conducted a cross-sectional in Prematurity and neonatal cardiovascular transition (n=118). Preterm birth vs. Term birth was evaluated on Myocardial performance index (MPI) compared to term neonates after PDA closure (p=<0.001). Preterm neonates at 40 weeks of postconceptional age demonstrated preserved left ventricular function, with a significantly lower myocardial performance index compared to term neonates after PDA closure (0.31 vs 0.39, p<0.001).
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