Abstract
Preterm infants and those with hypertrophic cardiomyopathy (HC) are frequently described as having a hypercontractile LV. Relationships between the extent of LV shortening and the force opposing shortening (wall stress (g)) reflect intrinsic LV function. The method for determining LV end systolic (ES) meridional g was validated in 8 children with normal LV undergoing catheterization (GpI). We then evaluated ESg in 20 preterm infants (4.8days) without PDA (GpII), 23 preterm infants (4.8days) with PDA (GpIII) and 11 term IDM (2.1days) with HC (GpIV). ESg was calculated from echo measurements of ES LV dimension (DES) and wall thickness (hES) and intraarterial or Doppler blood pressures.Preterm infants and IDM have a disproportionately thick LV. Their enhanced LV ejection performance is related to the reduced ESg (afterload). Compared to GpII, GpIII infants have even better ejection indices at the same ESg suggesting an effect of the increased preload or augmented inotropy, the latter possibly due to increased sympathetic tone.
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