Right Ventricular Performance in Preterm and Term Neonates: Reference Values of the Tricuspid Annular Peak Systolic Velocity Measured by Tissue Doppler Imaging

Abstract

Background: The tricuspid annular peak systolic velocity (S′) is an echocardiographic measurement to assess systolic right ventricular function in adults and children. Objective: We determined growth and birth weight-related changes of S′ to establish reference values in preterm and term neonates. Methods: A prospective study was conducted in a group of 290 preterm and term neonates (gestational age 26 + 0 to 40 + 6 weeks of gestation; birth weight 660-4,460 g). A correlation of S′ values with established tricuspid annular plane systolic excursion (TAPSE) values was performed. Results: The S′ ranged from a mean of 4.5 cm/s (Z-score ± 2 SD: 3.6-5.5 cm/s) in preterm neonates in week 26^0-6 of gestation to 7.8 cm/s (Z-score ± 2 SD: 5.5-10.1 cm/s) in term neonates in week 40^0-6 of gestation. The S′ values increased from 26 to 40 weeks of gestation. S′ and week of gestation are strongly correlated: Pearson's correlation coefficient was 0.66 for week of gestation - S′ (p < 0.001). A significant correlation was found between S′ and TAPSE values (r = 0.67; p < 0.001). Conclusion: Z-scores of S′ values were calculated and percentile charts were established to serve as reference data for preterm and term neonates with structurally normal hearts.