Left ventricular efficiency after ligation of patent ductus arteriosus for premature infants

As part of a multicenter collaborative study, M-mode echocardiograms were obtained shortly after birth on 3,559 premature infants with birth weight ≤1,750 g. Of these infants, 1,496 did not develop a cardiac murmur or other signs of a "hemodynamically significant" patent ductus arteriosus (PDA). Echocardiographic parameters from this "normal" group were compared with results obtained from 415 infants in whom PDA was diagnosed on the basis of clinical findings alone, irrespective of the echocardiogram (PDA group). The best discrimination between the two groups, when considering a single parameter, was provided by a left atrial to aortic root ratio (LA/AO) of 1.40, a left ventricular to aortic root ratio (LV/AO) of 2.10, or a left ventricular systolic time interval ratio (LPEP/LVET) of 0.27. Multivariate analysis demonstrated that better separation between the two groups occurred when the left atrial to aortic root ratio and the left ventricular systolic time interval ratio were considered jointly. Because of a large degree of overlap of all echocardiographic variables between the normal group and the group with PDA, the echocardiogram alone was not a good indicator of PDA. However, when used in conjunction with a priori estimates of the probability of PDA (based, for example, on birth weight and degree of respiratory disease), use of echocardiographic data was found to improve the detection of hemodynamically significant patent ductus arteriosus in premature infants.

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Effect of patent ductus arteriosus on left ventricular output in premature infants

The Journal of Pediatrics ◽

10.1016/s0022-3476(83)80252-2 ◽

1983 ◽

Vol 102 (5) ◽

pp. 754-757 ◽

Cited By ~ 56

Author(s):

Dale C. Alverson ◽

Marlowe W. Eldridge ◽

John D. Johnson ◽

Rochelle Burstein ◽

LuAnn Papile ◽

...

Keyword(s):

Patent Ductus Arteriosus ◽

Premature Infants ◽

Ductus Arteriosus ◽

Left Ventricular ◽

Left Ventricular Output ◽

Patent Ductus

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Patent ductus arteriosus ligation is associated with impaired left ventricular systolic performance in premature infants weighing less than 1000 g

Journal of Thoracic and Cardiovascular Surgery ◽

10.1016/j.jtcvs.2010.01.011 ◽

2010 ◽

Vol 140 (1) ◽

pp. 150-157 ◽

Cited By ~ 80

Author(s):

Patrick J. McNamara ◽

Lilian Stewart ◽

Sandesh P. Shivananda ◽

Derek Stephens ◽

Arvind Sehgal

Keyword(s):

Patent Ductus Arteriosus ◽

Premature Infants ◽

Ductus Arteriosus ◽

Left Ventricular ◽

Systolic Performance ◽

Patent Ductus

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Exploring the NT-proBNP expression in Premature Infants with Patent Ductus Arteriosus (PDA) by Echocardiography

Pakistan Journal of Medical Sciences ◽

10.12669/pjms.37.6-wit.4853 ◽

2021 ◽

Vol 37 (6-WIT) ◽

Author(s):

Yunlong Shi ◽

Jianwei Ji ◽

Chunying Wang

Keyword(s):

Patent Ductus Arteriosus ◽

Premature Infants ◽

Ductus Arteriosus ◽

General Information ◽

Left Ventricular ◽

Expression Level ◽

Left Ventricular Ejection ◽

Ventricular Ejection Fraction ◽

Specificity And Sensitivity ◽

Patent Ductus

Objectives: To investigate the correlation between echocardiographic indicators and the expression level of N-terminal pro-brain natriuretic peptide (NT-proBNP) in premature infants (PIs) with patent ductus arteriosus (PDA) and the value of NT-proBNP in diagnosing symptomatic PDA (sPDA) in PIs whose gestational age (GA) was less than 32 weeks. Methods: Ninty premature infants were selected as the research objects, including 52 in the non-PDA group and 38 in the PDA group (26 sPDA cases and 12 cases with asymptomatic PDA (asPDA)) from February 2019 to March 2020. The general information of these infants was recorded, including gender, delivery method, maternal infection, and serum NT-proBNP level on the 3rd day after birth. They were screened by echocardiographic indicators under an artificial intelligence convolutional neural network (AI-CNN). The Receiver Operating Characteristic (ROC) curves were illustrated to decide serum NT-proBNP expression levels, thereby determining specificity and sensitivity of sPDA and the correlation between serum sPDA NT-proBNP expression and echocardiographic indicators. Results: The expression level of serum NT-proBNP in the sPDA group was greater than that in the asPDA group and the non-PDA group (P<0.001). The serum NT-proBNP expression level was positively correlated with the diameter of the ductus arteriosus in the sPDA group (r=0.462, P<0.001); it was also positively correlated with the ratio of left atrium/aorta (LA/AO) (r=0.573, P<0.001), but was not correlated with left ventricular ejection fraction (LVEF) (r=-0.015, P=0.747). Conclusion: The combination of serum NT-proBNP expression and echocardiography had clinical values in early diagnosis of PDA. doi: https://doi.org/10.12669/pjms.37.6-WIT.4853 How to cite this:Shi Y, Ji J, Wang C. Exploring the NT-proBNP expression in Premature Infants with Patent Ductus Arteriosus (PDA) by Echocardiography. Pak J Med Sci. 2021;37(6):1615-1619. doi: https://doi.org/10.12669/pjms.37.6-WIT.4853 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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STUDY ON CLINICAL CHARACTERISTICS AND ECHOCARDIOGRAPHY DOPPLER OF PATENT DUCTUS ARTERISUS IN PREMATURE INFANTS AT PEDIATRIC DEPARTMENT OF HUE CENTRAL HOSPITAL

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2011.6.3 ◽

2011 ◽

pp. 30-35

Author(s):

Thi Le Huynh ◽

Hung Viet Phan ◽

Huu Hoa Pham

Keyword(s):

Birth Weight ◽

Patent Ductus Arteriosus ◽

Premature Infants ◽

Ductus Arteriosus ◽

Left Ventricular ◽

Heart Murmur ◽

Central Hospital ◽

Pediatric Department ◽

Echocardiography Doppler ◽

Patent Ductus

Background: Patent ductus arteriosus (PDA) is common in premature infants, specific in very low birth weight (VLBW) infants. Frequency of PDA is inversely related to gestational age. This is a cause that can lead to death because of complications, especially premature neonates. Objective: To define the rate and clinical features of the patent ductus arteriosus in premature infants. Describe the morphological and hemodynamic changes of the heart in premature infants with patent ductus arteriosus by echocardiography Doppler. Patients and methods: Included 159 premature infants are treated at the Pediatric Department of Hue Central Hospital from 5/2010 to 5/2011. All of them were performed clinical examination and echocardiography Doppler within 3 days after giving birth. Results: The patent ductus arteriosus detected by echocardiography in premature infants was 65.4%, especially extremely premature infants <28 weeks, birth weight <1000 grams. Clinical symptoms of patent ductus arteriosus in premature infants is rapidly breathing seen in 81.7%, cardiac hyperactivity in 70.2%, strong second heart sound in 61.5%, rapid heart frequency in 41.3% and heart murmur is the least common in 10.6% of cases. Ultrasound result showed that 100% was left-right shunt. 76% of infants have ductus arteriosus diameter ≥2.0 mm, average size of the ductus arteriosus was 2.16 ± 0.66 mm. Index LA/Ao, LVDd and LVDS of infants having the patent ductus arteriosus were higher than the infants having closed ductus arteriosus with p<0.05. Conclusion: Patent ductus arteriosus have very high rate in premature infant. Clinical diagnosis is often difficult because only 7% of cases having heart murmur. Index LA/Ao, systolic and diastolic left ventricular size of infants having the patent ductus arteriosus are higher than the infants having closed ductus arteriosus

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