Left ventricular contractile state in preterm infants: relation between wall stress and velocity of circumferential fiber shortening.

Fetal and newborn lambs' hearts have limited capacity to adapt to increased afterload. In human preterm infants, however, this limited left ventricular pump function has not been investigated. To determine the normal left ventricular resting contractile state in preterm infants, we studied the relation of end-systolic wall stress to the rate-corrected velocity of circumferential fiber shortening (VCF) in 11 preterm infants of gestational ages 28 to 36 weeks. We performed the first (7 to 14 days of postnatal age) and the second (29 to 39 days of postnatal age) examinations. There was a significant inverse linear correlation between wall stress and VCF in the first and the second examinations (r = -0.616 and r = -0.715, respectively). Both regression lines had slopes that were steeper than those previously reported for older age groups. The preterm infants had high VCF values (mean 1.05 and 1.09 cir/sec, respectively) and low-wall stress values (mean 36.0 and 36.9 gm/cm2, respectively) in the first and the second examinations. We therefore suggest that the preterm infants have a high resting contractile state, but left ventricular performance may deteriorate in the face of increased afterload.