Speckle tracking derived strain in infants with severe perinatal asphyxia: a comparative case control study

Cardiovascular Ultrasound

Research

Samuel Menahem¹  Arvind Sehgal²  Flora Wong² 

[1] Department of Pediatrics, Monash University, Melbourne, Australia;Monash Heart, Southern Health, Melbourne, Australia;Monash Newborn, Monash Medical Centre, VIC 3168, Melbourne, Australia;Department of Pediatrics, Monash University, Melbourne, Australia;

关键词: Asphyxia;    Neonates;    Speckle tracking;    Strain;   

DOI  :  10.1186/1476-7120-11-34

 received in 2013-07-16, accepted in 2013-08-27,  发布年份 2013

来源: Springer

【 摘 要 】

BackgroundSpeckle tracking echocardiography is increasingly being used to assess cardiac function in neonates. The objective was to compare speckle tracking strain indices between asphyxiated infants and healthy controls and to ascertain correlations between strain and 2D Doppler derived indices and cardiac troponin (biochemical marker of myocardial injury).MethodsClinical and echocardiographic data from severely asphyxiated infants undergoing therapeutic hypothermia was evaluated retrospectively. This was compared with prospective data from healthy infants. Correlations between variables were assessed using Pearson’s coefficient of correlation.ResultsTwenty four infants with severe perinatal asphyxia were admitted during the study period of which 3 were not cooled and were excluded. The gestational age and birth weights of cases and controls were comparable. The mean left ventricular global longitudinal strain (GLS) from apical 4 chamber view was noted to be significantly impaired in the asphyxiated infants (– 11.01% ± 2.48 vs – 21.45% ± 2.74, p <0.001). Cardiac output was significantly lower in the asphyxiated infants (97 ± 26 vs 230 ± 60 ml/kg/min). In asphyxiated infants, GLS correlated positively with cardiac output (r2 = 0.86, p< 0.001) and negatively with serum troponin levels (r2 = 0.64, p< 0.001). GLS was less impaired in infants on inotropes compared to those not on inotropic support, -12.55% (1.9) vs -10.2% (1.3), p= 0.018. Infants who died had a lower global strain value compared to survivors, – 9.7% (1.6) vs – 12.8% (2.6), p = 0.02.Conclusions2D Speckle derived strain was impaired in asphyxiated infants. Significant correlations between GLS and cardiac output and troponin were noted.

【 授权许可】

CC BY   
© Sehgal et al.; licensee BioMed Central Ltd. 2013