AIM: Persistent pulmonary hypertension of the newborn is a serious clinical entity with significant mortality and long-term morbidity. The objective was to study the profile of myocardial function, especially diastolic function, in term infants with pulmonary hypertension treated with nitric oxide. METHODS: Unit electronic database was accessed to identify infants ≥34 weeks gestation who were administered nitric oxide for pulmonary hypertension over the last 6 years. Medical records and archived echocardiographic images were retrieved. Those with no echocardiogram on the day of administration of nitric oxide, concomitant congenital heart disease or ≥2 weeks of age at the time of nitric administration were excluded. RESULTS: Low biventricular outputs were noted in >2/3rd infants. Tricuspid regurgitation was noted in 20/25 (80%) infants, and ductal shunt was bidirectional in the majority of cases. Right ventricular diastolic function was assessed by systolic to diastolic duration ratio; dysfunction was widely prevalent. CONCLUSIONS: A large percentage of infants were haemodynamically severely compromised. This is the first study to detail right ventricular diastolic dysfunction in infants with pulmonary hypertension and highlights the therapeutic role of milrinone, a lusitropic drug with myocardial relaxation properties. Comprehensive evaluation of cardiovascular haemodynamics can optimize clinical care.
AIM: Persistent pulmonary hypertension of the newborn is a serious clinical entity with significant mortality and long-term morbidity. The objective was to study the profile of myocardial function, especially diastolic function, in term infants with pulmonary hypertension treated with nitric oxide. METHODS: Unit electronic database was accessed to identify infants ≥34 weeks gestation who were administered nitric oxide for pulmonary hypertension over the last 6 years. Medical records and archived echocardiographic images were retrieved. Those with no echocardiogram on the day of administration of nitric oxide, concomitant congenital heart disease or ≥2 weeks of age at the time of nitric administration were excluded. RESULTS: Low biventricular outputs were noted in >2/3rd infants. Tricuspid regurgitation was noted in 20/25 (80%) infants, and ductal shunt was bidirectional in the majority of cases. Right ventricular diastolic function was assessed by systolic to diastolic duration ratio; dysfunction was widely prevalent. CONCLUSIONS: A large percentage of infants were haemodynamically severely compromised. This is the first study to detail right ventricular diastolic dysfunction in infants with pulmonary hypertension and highlights the therapeutic role of milrinone, a lusitropic drug with myocardial relaxation properties. Comprehensive evaluation of cardiovascular haemodynamics can optimize clinical care.
Authors: Joseph M Collaco; Lewis H Romer; Bridget D Stuart; John D Coulson; Allen D Everett; Edward E Lawson; Joel I Brenner; Anna T Brown; Melanie K Nies; Priya Sekar; Lawrence M Nogee; Sharon A McGrath-Morrow Journal: Pediatr Pulmonol Date: 2012-07-06
Authors: Aisling Smith; Jyothsna R Purna; Michael P Castaldo; Daniel Ibarra-Rios; Regan E Giesinger; Danielle R Rios; Dany E Weisz; Amish Jain; Afif F El-Khuffash; Patrick J McNamara Journal: Echocardiography Date: 2019-06-27 Impact factor: 1.724
Authors: Afif El-Khuffash; Patrick J McNamara; Colm Breatnach; Neidin Bussmann; Aisling Smith; Oliver Feeney; Elizabeth Tully; Joanna Griffin; Willem P de Boode; Brian Cleary; Orla Franklin; Eugene Dempsey Journal: Matern Health Neonatol Perinatol Date: 2018-12-03
Authors: Willem P de Boode; Yogen Singh; Zoltan Molnar; Ulf Schubert; Marilena Savoia; Arvind Sehgal; Philip T Levy; Patrick J McNamara; Afif El-Khuffash Journal: Pediatr Res Date: 2018-07 Impact factor: 3.756