Adam T James1, John David Corcoran2, Orla Franklin3, Afif Faisal El-Khuffash4. 1. Department of Neonatology, The Rotunda Hospital, Dublin, Ireland. 2. Department of Neonatology, The Rotunda Hospital, Dublin, Ireland; Department of Paediatrics, The Royal College of Surgeons in Ireland, Dublin, Ireland. 3. Department of Paediatric Cardiology, Our Lady's Children's Hospital Crumlin, Ireland. 4. Department of Neonatology, The Rotunda Hospital, Dublin, Ireland; Department of Paediatrics, The Royal College of Surgeons in Ireland, Dublin, Ireland. Electronic address: afifelkhuffash@rcsi.ie.
Abstract
INTRODUCTION: Right ventricular fractional area change (RV FAC) is a novel non-invasive quantitative measure of RV function. Reference values of RV FAC and RV end systolic and diastolic areas (RVEDA, RVESA) have recently been established in preterm infants, but their role as marker to assess the efficacy of patient management strategies in the first week of life is largely unknown. The aims of this study were to assess the relationship between RV FAC and gestational age/birthweight, assess the RV FAC on day one of age to predict the later evolution of peri/intraventricular haemorrhage (P/IVH), and assess the influence of a persistent patent ductus arteriosus (PDA) on RV FAC during the first week of age. METHODS: Preterm infants <29 weeks gestation underwent echocardiography assessments on days 1, 2 and 5-7. RVEDA and RVESA were traced in the RV-focused apical four-chamber view, and RV FAC was calculated using the formula [(RVEDA-RVESA)÷(RVEDA)] × 100. PDA treatment was not carried out during the study period. A cranial ultrasound was carried out on all infants on Days 5-7 of age. P/IVH was defined as IVH grades II to IV. RESULTS: One hundred and one infants with a mean gestation of 26.5 (1.4) weeks and a birthweight of 983 (240) grams were enrolled in the study. There was no relationship between RV FAC and birthweight (r=-0.02, p=0.86) but there was a negative correlation between RV FAC and echo-measured SVR (r=-0.57, p<0.001). On Day 1, RV FAC was lower in infants who developed P/IVH (24% [18-34] vs. 31% [25-40], p=0.04). On Days 5-7 infants with a PDA had a lower RV FAC compared with those without [42 (7) vs. 49 (9) %, p<0.001]. CONCLUSION: RV FAC may be a useful addition to the haemodynamic assessment of preterm infants during the first week of age.
INTRODUCTION: Right ventricular fractional area change (RV FAC) is a novel non-invasive quantitative measure of RV function. Reference values of RV FAC and RV end systolic and diastolic areas (RVEDA, RVESA) have recently been established in preterm infants, but their role as marker to assess the efficacy of patient management strategies in the first week of life is largely unknown. The aims of this study were to assess the relationship between RV FAC and gestational age/birthweight, assess the RV FAC on day one of age to predict the later evolution of peri/intraventricular haemorrhage (P/IVH), and assess the influence of a persistent patent ductus arteriosus (PDA) on RV FAC during the first week of age. METHODS: Preterm infants <29 weeks gestation underwent echocardiography assessments on days 1, 2 and 5-7. RVEDA and RVESA were traced in the RV-focused apical four-chamber view, and RV FAC was calculated using the formula [(RVEDA-RVESA)÷(RVEDA)] × 100. PDA treatment was not carried out during the study period. A cranial ultrasound was carried out on all infants on Days 5-7 of age. P/IVH was defined as IVH grades II to IV. RESULTS: One hundred and one infants with a mean gestation of 26.5 (1.4) weeks and a birthweight of 983 (240) grams were enrolled in the study. There was no relationship between RV FAC and birthweight (r=-0.02, p=0.86) but there was a negative correlation between RV FAC and echo-measured SVR (r=-0.57, p<0.001). On Day 1, RV FAC was lower in infants who developed P/IVH (24% [18-34] vs. 31% [25-40], p=0.04). On Days 5-7 infants with a PDA had a lower RV FAC compared with those without [42 (7) vs. 49 (9) %, p<0.001]. CONCLUSION: RV FAC may be a useful addition to the haemodynamic assessment of preterm infants during the first week of age.
Authors: Meghna D Patel; Colm R Breatnach; Adam T James; Swati Choudhry; Patrick J McNamara; Amish Jain; Orla Franklin; Aaron Hamvas; Luc Mertens; Gautam K Singh; Afif El-Khuffash; Philip T Levy Journal: J Am Soc Echocardiogr Date: 2019-07 Impact factor: 5.251
Authors: Philip T Levy; Afif El-Khuffash; Meghna D Patel; Colm R Breatnach; Adam T James; Aura A Sanchez; Cristina Abuchabe; Sarah R Rogal; Mark R Holland; Patrick J McNamara; Amish Jain; Orla Franklin; Luc Mertens; Aaron Hamvas; Gautam K Singh Journal: J Am Soc Echocardiogr Date: 2017-04-19 Impact factor: 5.251
Authors: Collin T Erickson; Meghna D Patel; Swati Choudhry; Karl Stessy Bisselou; Tim Sekarski; Mary Craft; Ling Li; Afif El Khuffash; Aaron Hamvas; Shelby Kutty; Gautam K Singh; Philip T Levy Journal: Cardiol Young Date: 2019-07-09 Impact factor: 1.093
Authors: Willem P de Boode; Yogen Singh; Samir Gupta; Topun Austin; Kajsa Bohlin; Eugene Dempsey; Alan Groves; Beate Horsberg Eriksen; David van Laere; Zoltan Molnar; Eirik Nestaas; Sheryle Rogerson; Ulf Schubert; Cécile Tissot; Robin van der Lee; Bart van Overmeire; Afif El-Khuffash Journal: Pediatr Res Date: 2016-06-08 Impact factor: 3.756
Authors: David van Laere; Bart van Overmeire; Samir Gupta; Afif El-Khuffash; Marilena Savoia; Patrick J McNamara; Christoph E Schwarz; Willem P de Boode Journal: Pediatr Res Date: 2018-07 Impact factor: 3.756