Myocardial Function Maturation in Very-Low-Birth-Weight Infants and Development of Bronchopulmonary Dysplasia

Frontiers in Pediatrics

article

Paula Méndez-Abad¹  Pamela Zafra-Rodríguez¹  Simón Lubián-López¹  Isabel Benavente-Fernández¹ 

[1] Department of Neonatology, Puerta del Mar University Hospital;Department of Pediatrics, Institute for Research and Innovation in Biomedical Sciences (INiBICA)

关键词: bronchopulmonary dysplasia;    preterm infants;    myocardial function;    N-terminal pro B type natriuretic peptide;    tissue doppler imaging;    targeted neonatal echocardiography;    biomarkers;    tricuspid annular plane systolic excursion;   

DOI  :  10.3389/fped.2019.00556

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

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.

【 授权许可】

CC BY