Respiratory Distress Syndrome: Echocardiographic Assessment of Cardiovascular Function and Pulmonary Vascular Resistance

PEDIATRICS ◽  
1977 ◽  
Vol 60 (4) ◽  
pp. 444-449
Author(s):  
Henry Halliday ◽  
Stephen Hirschfeld ◽  
Thomas Riggs ◽  
Jerome Liebman ◽  
Avroy Fanaroff ◽  
...  
Keyword(s):  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Right Ventricular ◽  
Pulmonary Vascular Resistance ◽  
Preterm Infants ◽  
Distress Syndrome ◽  
Systolic Time Intervals ◽  
Left Ventricular ◽  
Time Intervals ◽  
Systolic Time

Echocardiograms were performed for 82 preterm infants comprising 22 normal infants, 29 with mild respiratory distress syndrome (RDS), and 31 with severe RDS. Left ventricular systolic time intervals were measured from aortic valve echograms and right ventricular systolic time intervals from pulmonic valve echograms. Left ventricular performance seemed to be altered early in postnatal adaptation of preterm infants, but played no demonstrable role in the outcome of RDS. The right ventricular preejection period/right ventricular ejection time (RPEP/RVET) ratio was prolonged in 17 out of 31 patients with severe RDS, consistent with increased pulmonary vascular resistance or right ventricular dysfunction. Prolonged RPEP/RVET identified a subgroup with increased mortality and moribidity.

Echographic Ventricular Systolic Time Intervals in Normal Term and Preterm Neonates

PEDIATRICS ◽  
1978 ◽  
Vol 62 (3) ◽  
pp. 317-321
Author(s):  
Henry Halliday ◽  
Stephen Hirschfeld ◽  
Thomas Riggs ◽  
Jerome Liebman ◽  
Avroy Fanaroff
Keyword(s):  
Right Ventricular ◽  
Preterm Infants ◽  
Systolic Time Intervals ◽  
Left Ventricular ◽  
Ventricular Ejection ◽  
Ejection Time ◽  
Time Intervals ◽  
Normal Term ◽  
Systolic Time ◽  
Ventricular Ejection Time

Right ventricular and left ventricular systolic time intervals (RVSTIs and LVSTIs) were measured in normal term and preterm infants from 1 hour to 90 days of life. LVSTIs in both term and preterm infants were similar in the first five days of life. The ratio of left pre-ejection period (LPEP) to left ventricular ejection time (LVET) was lower in preterm infants older than age 5 days. Estimated gestational age had no influence on LVSTI. The ratio of right preejection period (RPEP) to right ventricular ejection time (RVET) was lower in preterm infants (0.32) than in term newborns (0.37). The preterm RPEP/RVET ratio decreased with age, but at a slower rate than in term babies. This was consistent with the lower pulmonary vascular resistance present in preterm infants.

Value of Systolic Time Intervals in the Diagnosis of Large Patent Ductus Arteriosus in Fluid-Restricted and Mechanically Ventilated Preterm Infants

PEDIATRICS ◽  
1984 ◽  
Vol 74 (6) ◽  
pp. 1069-1074
Author(s):  
François Heitz ◽  
Jean-Claude Fouron ◽  
Nicolaas H. van Doesburg ◽  
Harry Bard ◽  
François Teasdale ◽  
...  
Keyword(s):  
Patent Ductus Arteriosus ◽  
Right Ventricular ◽  
Ductus Arteriosus ◽  
Systolic Time Intervals ◽  
Left Ventricular ◽  
Ejection Time ◽  
Time Intervals ◽  
Systolic Time ◽  
Ventricular Ejection Time ◽  
Patent Ductus

M-mode echocardiographic features suggesting a patent ductus arteriosus are based on two groups of indirect criteria: dilation of the left cardiac cavities and changes of systolic time intervals. The reliability of the first group of criteria has been questioned in fluidlimited, mechanically ventilated preterm infants. The sensitivity of the systolic time intervals in the same circumstances is investigated. Twenty-three patients with a large patent ductus arteriosus were selected. Review of their echocardiograms shows that the sensitivity of the various criteria (expressed as percentage of positivity) was as follows: inversion of the ratio of left ventricular preejection period to right ventricular preejection period, 91.3%; left ventricular preejection period to left ventricular ejection time over right ventricular preejection period to right ventricular ejection time < 1, 83%; left atrium dilation, 74%; shortening of left ventricular preejection period, 70%; dilation of left ventricular internal dimensions in diastole, 65%; increase in left atrium/aorta, 52%; and decrease of left ventricular preejection period to left ventricular ejection time, 48%. Three criteria involving time intervals (left ventricular preejection period to right ventricular preejection period, left ventricular preejection period, and left ventricular preejection period to left ventricular ejection time) had 100% specificity. The lowest specificity was found with criteria involving the left atrium (left atrial to aortic root ratio 75% and left atrium 63%). It is concluded that study of systolic time intervals is a reliable means of detecting preterm infants with hemodynamically significant left-to-right shunt through a patent ductus arteriosus even if the infants are mechanically ventilated and fluid restricted.

Neonatal Circulatory Changes: An Echocardiographic Study

PEDIATRICS ◽  
1977 ◽  
Vol 59 (3) ◽  
pp. 338-344
Author(s):  
Thomas Riggs ◽  
Stephen Hirschfeld ◽  
Connie Bormuth ◽  
Avroy Fanaroff ◽  
Jerome Liebman
Keyword(s):  
Right Ventricular ◽  
Systolic Time Intervals ◽  
Left Ventricular ◽  
Ventricular Ejection ◽  
Left Ventricular Ejection ◽  
Ejection Time ◽  
Time Intervals ◽  
Systolic Time ◽  
The Right ◽  
Ventricular Ejection Time

Serial echocardiograms were performed in the first three days of life on 38 normal full-term infants. Right ventricular systolic time intervals were measured from the pulmonic valve echogram and left ventricular systolic time intervals were determined from the aortic valve echogram. The heart rate, left ventricular pre-ejection period (LPEP), left ventricular ejection time (LVET), and LPEP/LVET ratio showed insignificant variation with increasing postnatal age. The right ventricular pre-ejection period (RPEP) shortened, the right ventricular ejection time (RVET) lengthened, and the RPEP/RVET ratio decreased with increasing age. The findings suggested that alterations in the RPEP/RVET ratio reflected the decreasing pulmonary artery diastolic pressure and pulmonary vascular resistance of the early neonatal period and may be valuable in the noninvasive evaluation of the newborn's pulmonary vascular bed.

scholarly journals Predictors of Long-term Right Ventricular Dysfunction in Acute Respiratory Distress Syndrome Survivors

2021 ◽  
Author(s):  
Siddharth Dugar ◽  
Ryota Sato ◽  
Hari Om Joshi ◽  
Xiaozhen Han ◽  
Xiaofeng Wang ◽  
...  
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Right Ventricular ◽  
Distress Syndrome ◽  
Cleveland Clinic ◽  
Right Ventricular Dysfunction ◽  
Left Ventricular ◽  
Post Discharge

Abstract Background: Right ventricular (RV) dysfunction develops frequently in patients with acute respiratory distress syndrome and is associated with short-term mortality. However, the incidence of long-term RV dysfunction and risk factor associated with it in ARDS survivors remains unknown. The aim of the study was to assess the prevalence and risk factors of long-term RV dysfunction in ARDS survivors. Method: This is a single-center retrospective cohort study including adult patients with ARDS admitted to the medical intensive care unit (MICU) at Cleveland Clinic between 1/1/2010–12/31/2017. We included patients with ARDS, who had echocardiography performed within 72 hours of MICU admission, survived 90 days from onset of ARDS with post-discharge echocardiography performed between 30-365 days after hospital discharge. RV dysfunction was defined based on the American Society of Echocardiography guidelines. Results: Of the 689 patients who were admitted to Cleveland Clinic for ARDS during the study period, 67 (14.07%) patients met the study criteria. A total of 34 patients (50. 7%) had RV dysfunction on post-discharge echocardiogram. In the multivariate logistic regression analyses, the incidence of long-term RV dysfunction was associated only with RVEDA/LVEDA [odds ratio (OR): 589, 95% confidence interval (CI): 71.17-48,400, p=0.005]. Conclusion: More than half of ARDS survivors had developed long-term RV dysfunction at post-discharge echocardiogram. Increased ratio of right-to-left ventricular end-diastolic area (RVEDA/LVEDA) ratio during ARDS was the significantly associated with development of long-term RV dysfunction in ARDS survivors. Trial registration: This study was approved by the Institutional Review Committee of Cleveland Clinic (IRB#19-1200) .

Echocardiographic Assessment of Cardiac Function During Respiratory Syncytial Virus Infection

PEDIATRICS ◽  
1988 ◽  
Vol 81 (6) ◽  
pp. 830-834
Author(s):  
Elfriede Pahl ◽  
Samuel S. Gidding
Keyword(s):  
Respiratory Syncytial Virus ◽  
Virus Infection ◽  
Right Ventricular ◽  
Ventricular Function ◽  
Systolic Time Intervals ◽  
Left Ventricular ◽  
Time Intervals ◽  
Doppler Flow ◽  
Systolic Time ◽  
Syncytial Virus

Respiratory syncytial virus infection has been associated with increased morbidity and mortality in infants with underlying cardiac and pulmonary disease. To understand better the cardiopulmonary interaction in patients with acute respiratory syncytial virus bronchiolitis, we performed M-mode echocardiograms and pulsed Doppler assessment of pulmonary arterial flow in 19 patients with structurally normal hearts during acute illness. Studies were repeated in 11 of these patients following complete recovery. Based on severity of respiratory compromise, patients were grouped into those with severe illness (ten patients) or mild illness (nine patients). Left ventricular dimensions and shortening fraction were used to assess left ventricular function. Right ventricular systolic time intervals and specific Doppler flow velocity measurements were used to assess right ventricular function and elevation of pulmonary artery pressure. Comparisons were made between patients with severe and mild illness and between acute and follow-up studies. No statistically significant differences in left ventricular function, right ventricular systolic time intervals, or Doppler flow measurements were observed. We conclude that in patients with structurally normal hearts, respiratory syncytial virus bronchiolitis is not associated with significant depression of cardiac performance or elevation in pulmonary resistance.

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