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

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.

PEDIATRICS ◽  
1977 ◽  
Vol 59 (3) ◽  
pp. 338-344
Author(s):  
Thomas Riggs ◽  
Stephen Hirschfeld ◽  
Connie Bormuth ◽  
Avroy Fanaroff ◽  
Jerome Liebman

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.


PEDIATRICS ◽  
1984 ◽  
Vol 74 (6) ◽  
pp. 1069-1074
Author(s):  
François Heitz ◽  
Jean-Claude Fouron ◽  
Nicolaas H. van Doesburg ◽  
Harry Bard ◽  
François Teasdale ◽  
...  

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.


1976 ◽  
Vol 41 (1) ◽  
pp. 52-56 ◽  
Author(s):  
T. B. Graboys ◽  
E. D. Michaelson

Systolic time intervals (STI) were recorded in 8 healthy male volunteersbefore, during, and after 30-s exposures to +3 Gz, +5 Gz, and +7 Gz acceleration. Heart rate (HR) increased at all +Gz levels, as did the HR correctedQSIc interval, left ventricular ejection time (LVETc), preejection period (PEPc) and PEP/LVET. These changes in STI were also proportional to the +Gz level. At the higher +Gz levels, PEPc and PEP/LVET continued to increase early in the recovery period, but HR and all STI returned to control after 60s of recovery. Although physiological variables other than myocardial contractility, such as preload and afterload may influence STI during +Gz the effects of +Gz on stroke volume (SV) and cardiac output (CO) were estimated using previously described relationships between STI and invasively determined indices of cardiovascular function. In general CO increased as SV decreased. During recovery, HR and CO fell and CO remained slightly below controllevels, primarily because estimated SV remained low. This study demonstrates the feasibility of using STI to estimate noninvasively the transient changes in cardiovascular function during +Gz acceleration.


1978 ◽  
Vol 87 (3) ◽  
pp. 507-515 ◽  
Author(s):  
J. Chakravarty ◽  
A. R. Guansing ◽  
S. Chakravarty ◽  
C. V. Hughes

ABSTRACT Systolic time intervals consisting of indices of electromechanical systole (QS2-I), left ventricular ejection time (LVET-I) and pre-ejection period (PEP-I) were calculated serially during therapy in 12 euthyroid, 9 hypothyroid and 9 hyperthyroid individuals. These parameters were analyzed sequentially together with the changes in serum thyroxine (T4), triiodothyronine (T3) and thyrotrophin (TSH) in order to determine the sensitivity of these non-invasive procedures in monitoring peripheral thyroid hormone effect. The results are expreseed in mean ± sem. QS2-I (506.3 ± 8.2 ms) and PEP-I (102.9 ± 4.2) were shortened (P < 0.02 and P < 0.001, respectively) in hyperthyroidism and prolonged (579.3 ± 7.3 and 169.6 ± 3.6 ms) in hypothyroidism (P < 0.01 and P < 0.001, respectively) compared to euthyroid controls (538.1 ± 8.8 and 130.3 ± 5.3 ms), while LVET-I did not change significantly in either condition. Simultaneous determinations of circulating T4, T3 and TSH showed changes appropriate to both hypo- and hyperthyroid states. In 2 patients with T3-thyrotoxicosis, PEP-I was decreased to an average of 103.1 ms, while in 2 patients with compensated hypothyroidism (normal T4 but elevated TSH) this was prolonged to 163.7 ms (average) compared to euthyroid controls. During treatment the hypothyroid group showed significant sequential correlation of TSH and PEP-I. In the hyperthyroid individuals, PEP-I correlated significantly with T4 and T3. PEP-I may be a useful, sensitive, quantitative biologic indicator of thyroid hormone effect on myocardial function.


1980 ◽  
Vol 136 (5) ◽  
pp. 603-608 ◽  
Author(s):  
Yuji Murata ◽  
Chester B. Martin ◽  
Tsuyomu Ikenoue ◽  
Roy H. Petrie

PEDIATRICS ◽  
1977 ◽  
Vol 60 (4) ◽  
pp. 444-449
Author(s):  
Henry Halliday ◽  
Stephen Hirschfeld ◽  
Thomas Riggs ◽  
Jerome Liebman ◽  
Avroy Fanaroff ◽  
...  

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.


1978 ◽  
Vol 44 (1) ◽  
pp. 55-58 ◽  
Author(s):  
L. A. Wolfe ◽  
D. A. Cunningham ◽  
G. M. Davis ◽  
P. A. Rechnitzer

Externally recorded systolic time intervals (STI's), indirect (CO2 re-breathing) cardiac output, and auscultatory blood pressures were measured during upright bicycle ergometer work in 20 healthy men, aged 24–56 yr. The subjects were studied on 2 separate days at steady-state work loads chosen to represent light (mean heart rate (HR) = 96 beats.min-1), moderate (HR = 118 beats.min-1) and heavy (HR = 147 beats.min-1) exercise. In addition to determinations of cardiac output, systolic time intervals, and blood pressure, the individual's mean systolic ejection rate (stroke volume/left ventricular ejection time) was calculated as a measure of left ventricular function. In general, heart-rate-corrected STI's were found to be reliable and reproducible. Reliability coefficients for total electromechanical systole and left ventricular ejection time ranged from 0.93 to 0.96 while those for the preejection period and its subcomponents were between 0.63 and 0.88. The reliability of cardiac output, stroke volume, mean systolic ejection rate, and systolic blood pressure was also considered to be acceptable but tended to be higher during moderate and heavy work (r = 0.85–0.95) compared to light exercise (r = 0.60–0.83).


1992 ◽  
Vol 4 (1) ◽  
pp. 85-93 ◽  
Author(s):  
Barbara N. Campaigne ◽  
Kyle W. Landt ◽  
Frederick W. James ◽  
Joan Reimar ◽  
Wayne Mays ◽  
...  

Systolic time intervals (STI) were measured before and after exercise in 18 diabetic adolescents (D) and 18 age- and sex-matched nondiabetic controls (C). At similar heart rates, pre-exercise pre-ejection period (PEP) and left ventricular ejection time (LVET) were significantly shorter in D compared to C (p<0.05). There was no difference between the two groups in the PEP/LVET ratio. Following exercise there were no differences in STIs between groups. However, the change in PEP and LVET from pre- to postexercise was significantly less in D compared to C (delta PEP 38 vs. 53±3 msec, p<0.01; delta LVET 120 vs. 134±4 msec, p<0.05). These data suggest a hypercontractile state at rest in D and a blunted response to exercise when compared to C. This study provides data that may be relevant to the early identification of individuals at risk for premature diabetic cardiomyopathy.


2016 ◽  
Vol 6 (4) ◽  
pp. 508-515 ◽  
Author(s):  
Arvind Sehgal ◽  
Andra Malikiwi ◽  
Eldho Paul ◽  
Kenneth Tan ◽  
Samuel Menahem

Pulmonary hypertension (PH) and right ventricular function are the focus of cardiovascular effects of bronchopulmonary dysplasia (BPD). We assessed cardiac indexes reflecting systemic afterload and pulmonary venous back pressure as pathophysiologic factors. Cardiac parameters were measured by conventional echocardiography in 20 preterm infants with severe BPD and compared with those of 10 preterm infants with no BPD and 20 healthy term infants. In infants with severe BPD, PH was noted in 5 (25%) by tricuspid regurgitation Doppler jet ≥2.8 m/s and in 15 (75%) by time to peak velocity/right ventricular ejection time <0.34. Among systemic cardiac indexes, significant impairment of diastolic measures was noted in the BPD group compared with infants with no BPD and term infants. The significance persisted after adjusting for gestational age and birth weight. These included transmitral E/A ratio (1.07 ± 0.07 vs. 0.91 ± 0.04 vs. 0.89 ± 0.09; P < 0.0001), isovolumic relaxation time (68.8 ± 3.9 vs. 58.5 ± 7.8 vs. 54.2 ± 5.7 ms; P < 0.0001), mitral valve stroke volume (4.7 ± 0.7 vs. 5.6 ± 0.6 vs. 5.9 ± 0.1; P = 0.002), and myocardial performance index (0.33 ± 0.05 vs. 0.28 ± 0.01 vs. 0.27 ± 0.05; P = 0.03). Left ventricular output was significantly lower in the BPD cohort (183 ± 45 vs. 189 ± 9 vs. 191 ± 32 mL/kg/min; P = 0.03). Altered systemic (left-sided) cardiac function was noted in infants with BPD, which may lead to pulmonary venous congestion contributing to a continued need for respiratory support.


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