Abstract
Background: Myocardial function in very-low-birth-weight infants (VLBWIs) develops during early postnatal life, but different patterns of temporal evolution that might be related to the development of bronchopulmonary dysplasia (BPD) are not completely understood.Methods: A prospective cohort study including VLBWIs admitted to our NICU from January 2015 to 2017 was conducted. Plasma N-terminal pro B type natriuretic peptide (NTproBNP) levels were measured, and echocardiograms were performed at 24 and 72 h of life and weekly thereafter until 36 weeks of postmenstrual age (PMA). We measured the tricuspid annular plane systolic excursion (TAPSE) by M-mode; the lateral tricuspid E', A', and S' waves; and the myocardial performance index (MPI) by tissue doppler imaging (TDI). The subjects were divided into non-BPD and BPD groups.Results: We included 101 VLBWIs. The TAPSE and E', A', and S' waves increased while MPI-TDI decreased over time. Birth gestational age (GA) and postnatal PMA impacted these parameters, which evolved differently in those who developed BPD compared to those in the non-BPD group. The NTproBNP levels at 14 days of life and different echocardiographic parameters were associated with the development of BPD in different multivariate models.Conclusion: TAPSE and TDI values depend on GA and PMA and follow a different temporal evolution that is related to the later development of BPD. Combined biochemical and echocardiographic biomarkers can help identify which VLBWIs are at higher risk of developing BDP.
Highlights
Bronchopulmonary dysplasia (BPD) is a severe complication of prematurity that impacts the survival and development of very-low-birth-weight infants (VLBWIs) [1]
This study aims to evaluate the temporal evolution of VLBWI myocardial function related to gestational age (GA) and postmenstrual age (PMA) and to explore the potential role of right ventricle (RV) tissue Doppler imaging (TDI)-derived measurements, tricuspid annular plane systolic excursion (TAPSE) and NTproBNP together to detect early signs of myocardial dysmaturation in infants who develop BPD
We studied the temporal evolution of the TAPSE, E’, A, and S’ velocities of the RV in the “healthy VLBWI” subgroup, related to GA and PMA
Summary
Bronchopulmonary dysplasia (BPD) is a severe complication of prematurity that impacts the survival and development of very-low-birth-weight infants (VLBWIs) [1]. There is an increasing body of research aiming to identify early markers associated with BPD development in VLBWIs that could help identify high-risk infants who would benefit from potential preventive strategies [3, 4]. There has been growing research interest in the potential role of conventional and emerging echocardiographic modalities, such as tissue Doppler imaging (TDI), in the assessment of newborn and VLBWIs cardiopulmonary morbidities including patent ductus arteriosus (PDA) and BPD [6]. Myocardial function in very-low-birth-weight infants (VLBWIs) develops during early postnatal life, but different patterns of temporal evolution that might be related to the development of bronchopulmonary dysplasia (BPD) are not completely understood
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