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Left atrium function and deformation in very preterm infants with and without volume load
Background Left atrium (LA) function can be assessed by volumetric measurements, conventional and tissue Doppler, and more recently, deformation imaging using two‐dimensional speckle tracking echocardiography (2DSTE). 2DSTE allows for measurement of volume and deformation and can quantify the contri...
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| Published in: | Echocardiography (Mount Kisco, N.Y.) N.Y.), 2018-11, Vol.35 (11), p.1818-1826 |
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| container_title | Echocardiography (Mount Kisco, N.Y.) |
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| creator | Waal, Koert Phad, Nilkant Boyle, Andrew |
| description | Background
Left atrium (LA) function can be assessed by volumetric measurements, conventional and tissue Doppler, and more recently, deformation imaging using two‐dimensional speckle tracking echocardiography (2DSTE). 2DSTE allows for measurement of volume and deformation and can quantify the contribution of the reservoir, conduit, and contraction phase. A common cause for LA dysfunction in very preterm infants is volume overload with a patent ductus arteriosus (PDA). The aim of this study was to explore the feasibility and reliability of LA 2DSTE in preterm infants, and describe LA function with and without PDA volume load.
Methods
We prospectively recruited preterm infants |
| doi_str_mv | 10.1111/echo.14140 |
| format | article |
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Left atrium (LA) function can be assessed by volumetric measurements, conventional and tissue Doppler, and more recently, deformation imaging using two‐dimensional speckle tracking echocardiography (2DSTE). 2DSTE allows for measurement of volume and deformation and can quantify the contribution of the reservoir, conduit, and contraction phase. A common cause for LA dysfunction in very preterm infants is volume overload with a patent ductus arteriosus (PDA). The aim of this study was to explore the feasibility and reliability of LA 2DSTE in preterm infants, and describe LA function with and without PDA volume load.
Methods
We prospectively recruited preterm infants <30 weeks of gestation referred for assessment of a possible PDA. A cardiac ultrasound was performed at day 3 and in week 4 of life and analyzed using conventional techniques and 2DSTE.
Results
Forty‐eight infants (32 with PDA) were included. LA 2DSTE analysis was feasible in 96% of measurements with good reliability of strain and volume parameters. Strain rate was less reliable. Poorer LA contraction and reservoir function was associated with larger LA volume index, higher inflow over the mitral valve at early diastole, higher EA ratio, and higher Ee’ ratio. Poorer conduit function was associated with higher Ee’ ratio. A larger PDA diameter was found to be an independent contributor to deteriorating LA contraction and reservoir function.
Conclusion
LA 2DSTE analysis is feasible in preterm infants and provides detailed information on atrium mechanics. Further studies are needed to explore the clinical value of these new parameters in this population.</description><identifier>ISSN: 0742-2822</identifier><identifier>EISSN: 1540-8175</identifier><identifier>DOI: 10.1111/echo.14140</identifier><identifier>PMID: 30225864</identifier><language>eng</language><publisher>United States</publisher><subject>Atrial Function, Left - physiology ; deformation ; Ductus Arteriosus, Patent - diagnostic imaging ; Ductus Arteriosus, Patent - pathology ; Ductus Arteriosus, Patent - physiopathology ; echocardiography ; Echocardiography - methods ; Feasibility Studies ; Female ; Heart Atria - diagnostic imaging ; Heart Atria - pathology ; Heart Atria - physiopathology ; Humans ; Infant, Newborn ; Infant, Premature ; left atrium ; Male ; Organ Size ; patent ductus arteriosus ; Prospective Studies ; Reproducibility of Results ; speckle tracking ; strain ; volume</subject><ispartof>Echocardiography (Mount Kisco, N.Y.), 2018-11, Vol.35 (11), p.1818-1826</ispartof><rights>2018 Wiley Periodicals, Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3290-9c42acb2da493f813bcdbafec2332c95eb05382ff0199a7a607c87d89af79a653</citedby><cites>FETCH-LOGICAL-c3290-9c42acb2da493f813bcdbafec2332c95eb05382ff0199a7a607c87d89af79a653</cites><orcidid>0000-0002-1084-1482</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30225864$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Waal, Koert</creatorcontrib><creatorcontrib>Phad, Nilkant</creatorcontrib><creatorcontrib>Boyle, Andrew</creatorcontrib><title>Left atrium function and deformation in very preterm infants with and without volume load</title><title>Echocardiography (Mount Kisco, N.Y.)</title><addtitle>Echocardiography</addtitle><description>Background
Left atrium (LA) function can be assessed by volumetric measurements, conventional and tissue Doppler, and more recently, deformation imaging using two‐dimensional speckle tracking echocardiography (2DSTE). 2DSTE allows for measurement of volume and deformation and can quantify the contribution of the reservoir, conduit, and contraction phase. A common cause for LA dysfunction in very preterm infants is volume overload with a patent ductus arteriosus (PDA). The aim of this study was to explore the feasibility and reliability of LA 2DSTE in preterm infants, and describe LA function with and without PDA volume load.
Methods
We prospectively recruited preterm infants <30 weeks of gestation referred for assessment of a possible PDA. A cardiac ultrasound was performed at day 3 and in week 4 of life and analyzed using conventional techniques and 2DSTE.
Results
Forty‐eight infants (32 with PDA) were included. LA 2DSTE analysis was feasible in 96% of measurements with good reliability of strain and volume parameters. Strain rate was less reliable. Poorer LA contraction and reservoir function was associated with larger LA volume index, higher inflow over the mitral valve at early diastole, higher EA ratio, and higher Ee’ ratio. Poorer conduit function was associated with higher Ee’ ratio. A larger PDA diameter was found to be an independent contributor to deteriorating LA contraction and reservoir function.
Conclusion
LA 2DSTE analysis is feasible in preterm infants and provides detailed information on atrium mechanics. Further studies are needed to explore the clinical value of these new parameters in this population.</description><subject>Atrial Function, Left - physiology</subject><subject>deformation</subject><subject>Ductus Arteriosus, Patent - diagnostic imaging</subject><subject>Ductus Arteriosus, Patent - pathology</subject><subject>Ductus Arteriosus, Patent - physiopathology</subject><subject>echocardiography</subject><subject>Echocardiography - methods</subject><subject>Feasibility Studies</subject><subject>Female</subject><subject>Heart Atria - diagnostic imaging</subject><subject>Heart Atria - pathology</subject><subject>Heart Atria - physiopathology</subject><subject>Humans</subject><subject>Infant, Newborn</subject><subject>Infant, Premature</subject><subject>left atrium</subject><subject>Male</subject><subject>Organ Size</subject><subject>patent ductus arteriosus</subject><subject>Prospective Studies</subject><subject>Reproducibility of Results</subject><subject>speckle tracking</subject><subject>strain</subject><subject>volume</subject><issn>0742-2822</issn><issn>1540-8175</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><recordid>eNp9kE1Lw0AQhhdRbK1e_AGyRxFS9ytN9iilWqHQix48LZvNLI0k2bq7aem_N23Uo3OZeeHhHXgQuqVkSvt5BLNxUyqoIGdoTFNBkpxm6Tkak0ywhOWMjdBVCJ-EkIxScYlGnDCW5jMxRh8rsBHr6KuuwbZrTaxci3Vb4hKs840-5arFO_AHvPUQwTd9trqNAe-ruDnBx8N1Ee9c3TWAa6fLa3RhdR3g5mdP0Pvz4m2-TFbrl9f50yoxnEmSSCOYNgUrtZDc5pQXpiy0BcM4Z0amUJCU58xaQqXUmZ6RzORZmUttM6lnKZ-g-6F3691XByGqpgoG6lq34LqgGCWy_0Ql6dGHATXeheDBqq2vGu0PihJ1VKmOKtVJZQ_f_fR2RQPlH_rrrgfoAOyrGg7_VKnFfLkeSr8Biy9_Yw</recordid><startdate>201811</startdate><enddate>201811</enddate><creator>Waal, Koert</creator><creator>Phad, Nilkant</creator><creator>Boyle, Andrew</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-1084-1482</orcidid></search><sort><creationdate>201811</creationdate><title>Left atrium function and deformation in very preterm infants with and without volume load</title><author>Waal, Koert ; Phad, Nilkant ; Boyle, Andrew</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3290-9c42acb2da493f813bcdbafec2332c95eb05382ff0199a7a607c87d89af79a653</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Atrial Function, Left - physiology</topic><topic>deformation</topic><topic>Ductus Arteriosus, Patent - diagnostic imaging</topic><topic>Ductus Arteriosus, Patent - pathology</topic><topic>Ductus Arteriosus, Patent - physiopathology</topic><topic>echocardiography</topic><topic>Echocardiography - methods</topic><topic>Feasibility Studies</topic><topic>Female</topic><topic>Heart Atria - diagnostic imaging</topic><topic>Heart Atria - pathology</topic><topic>Heart Atria - physiopathology</topic><topic>Humans</topic><topic>Infant, Newborn</topic><topic>Infant, Premature</topic><topic>left atrium</topic><topic>Male</topic><topic>Organ Size</topic><topic>patent ductus arteriosus</topic><topic>Prospective Studies</topic><topic>Reproducibility of Results</topic><topic>speckle tracking</topic><topic>strain</topic><topic>volume</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Waal, Koert</creatorcontrib><creatorcontrib>Phad, Nilkant</creatorcontrib><creatorcontrib>Boyle, Andrew</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Echocardiography (Mount Kisco, N.Y.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Waal, Koert</au><au>Phad, Nilkant</au><au>Boyle, Andrew</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Left atrium function and deformation in very preterm infants with and without volume load</atitle><jtitle>Echocardiography (Mount Kisco, N.Y.)</jtitle><addtitle>Echocardiography</addtitle><date>2018-11</date><risdate>2018</risdate><volume>35</volume><issue>11</issue><spage>1818</spage><epage>1826</epage><pages>1818-1826</pages><issn>0742-2822</issn><eissn>1540-8175</eissn><abstract>Background
Left atrium (LA) function can be assessed by volumetric measurements, conventional and tissue Doppler, and more recently, deformation imaging using two‐dimensional speckle tracking echocardiography (2DSTE). 2DSTE allows for measurement of volume and deformation and can quantify the contribution of the reservoir, conduit, and contraction phase. A common cause for LA dysfunction in very preterm infants is volume overload with a patent ductus arteriosus (PDA). The aim of this study was to explore the feasibility and reliability of LA 2DSTE in preterm infants, and describe LA function with and without PDA volume load.
Methods
We prospectively recruited preterm infants <30 weeks of gestation referred for assessment of a possible PDA. A cardiac ultrasound was performed at day 3 and in week 4 of life and analyzed using conventional techniques and 2DSTE.
Results
Forty‐eight infants (32 with PDA) were included. LA 2DSTE analysis was feasible in 96% of measurements with good reliability of strain and volume parameters. Strain rate was less reliable. Poorer LA contraction and reservoir function was associated with larger LA volume index, higher inflow over the mitral valve at early diastole, higher EA ratio, and higher Ee’ ratio. Poorer conduit function was associated with higher Ee’ ratio. A larger PDA diameter was found to be an independent contributor to deteriorating LA contraction and reservoir function.
Conclusion
LA 2DSTE analysis is feasible in preterm infants and provides detailed information on atrium mechanics. Further studies are needed to explore the clinical value of these new parameters in this population.</abstract><cop>United States</cop><pmid>30225864</pmid><doi>10.1111/echo.14140</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-1084-1482</orcidid></addata></record> |
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| language | eng |
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| source | Wiley-Blackwell Read & Publish Collection |
| subjects | Atrial Function, Left - physiology deformation Ductus Arteriosus, Patent - diagnostic imaging Ductus Arteriosus, Patent - pathology Ductus Arteriosus, Patent - physiopathology echocardiography Echocardiography - methods Feasibility Studies Female Heart Atria - diagnostic imaging Heart Atria - pathology Heart Atria - physiopathology Humans Infant, Newborn Infant, Premature left atrium Male Organ Size patent ductus arteriosus Prospective Studies Reproducibility of Results speckle tracking strain volume |
| title | Left atrium function and deformation in very preterm infants with and without volume load |
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