0231: Neonatal left ventricular 2D strain to predict aortic coarctation

Abstract

Although coarctation of the aorta could be suspected prenatally, the diagnosis is not certain before birth and remains difficult in the neonatal period especially when ductus arteriosus is open. 2D strain, a recent echocardiographic tool to assess myocardial performance, allows the early detection of abnormal myocardial deformation. The aim of this study was to assess the accuracy of left ventricular 2D strain to predict aortic coarctation in neonates with patent ductus arteriosus. This was a single centre prospective study. Neonates with patent ductus arteriosus and prenatal/postnatal suspicion of isthmic coarctation were included. Left ventricular (LV) 2D strain was performed for each patient. Patients were divided into three groups: those who developed coarctation (group 1, n=9), those who had normal aorta after ductal closure (group 2, n=10), and a control group of healthy neonates with patent ductus arteriosus (group 3, n=20). The median age of gestation was 38+4 weeks of amenorrhea and the median birth weight was 3.088kg. The inter observer agreement was good for the assessment of LV 2D strain. Although radial strain was significantly decreased in group 1 (17.76 vs 40.19 in group 2, p<0.001), there was only a trend in the alteration of longitudinal and circumferential strain (-16.34 vs -16.84, p=0.059 & -10.41 vs – 13.88, p=0.053 respectively). LV 2D strain seems to be effective for the early diagnosis of aortic coarctation before the ductus arteriosus closes.