PS-013 Arterial-ventricular Coupling In Preterm Infants Below 30 Weeks Of Gestational Age

Abstract

Background and aim The model of arterial-ventricular coupling (AVC) describes the interaction of the left ventricle (E LV ) with the arterial system (E A ) by the AVC-ratio (AVC = E A /E LV ). Aim was to apply the model to preterm haemodynamics and to analyse time courses of AVC, E A and E LV in sick preterms with either pulmonary hypertension (PH-group) or haemodynamically significant patent ductus arteriosus (hPDA-group) and in stable preterms with uncomplicated postpartal course (control-group). Methods Study period was from 10/2009 to 12/2012. Patient recruitment criteria were as follows: anti-PH treatment due to (supra-) systemic pulmonary pressure on echocardiography (PH-group); presence of PDA with an enddiastolic maximal velocity in the left pulmonary artery (LPAdia) ≥ 0,2 m/s and negative history of PH (hPDA-group); neither anti-PH treatment nor catecholamines, PDA with an LPAdia Results Twentyone preterms were recruited to the PH-group, 19 to the hPDA-group and 63 to the control-group. AVC was lower in the PH- and hPDA-group than in the control-group (p = 0,05). E LV was higher in the PH-group (p = 0,007) and both E A and E LV were lower in the hPDA-group (E A : p = 0,0002; E LV : p = 0,02). Conclusion The AVC-ratio was lower in sick preterms. Higher E LV in PH results from interventricular interdependence with decreased LV-filling. Lower E LV and E A in PDA result from LV-volume-overload and systemic steal-effect. Applying the AVC-model may facilitate explaining preterm haemodynamics.