WIP 54 - Evaluation of Biventricular Systolic and Diastolic Function in Preterm Infants in the First Week of Postnatal Life

Publication Number: WIP 54.7700

Ivonne E. Sierra-Strum, Keck School of Medicine of the University of Southern California, ALHAMBRA, CA, United States; Piyawat Arichai, Children's Hospital Los Angeles, Pasadena, CA, United States; Rowena Cayabyab, Los Angeles General Medical Center, Los Angeles, CA, United States; Hemananda Muniraman, University of South california, Los Angeles, CA, United States; Rangasamy Ramanathan, Cedars Sinai Guerin Children's, Los Angeles, CA, United States

Background: Advances in neonatal intensive care have improved survival for very low birth weight (VLBW) infants. However, these infants remain vulnerable to altered hemodynamics due to immature myocardial function affecting contractility and relaxation.Limited data exist on early indicators of diastolic dysfunction in this population

Objective: This study aims to evaluate changes in systolic and diastolic myocardial performance over the first week of life to establish normative trends and assess associations between cardiac function and early clinical outcomes, such as intraventricular hemorrhage (IVH), pulmonary hemorrhage, and hypotension

Design/Methods: This prospective study includes preterm infants (Birth weight < 1500g or < 32 wks Gestational age) admitted to the NICU at Los Angeles General Medical Center. IRB approval was obtained, and infants meeting criteria were enrolled. Exclusion criteria include congenital heart disease, severe instability, and genetic abnormalities. Transthoracic echocardiograms (TTE) are conducted at 24, 48, 72 hrs, and one week of life. Parameters include mitral E/A ratios, Tissue doppler imaging (TDI) velocities, E/e’ ratios, and Left ventricular output (LVO). Right ventricular function will be assessed via tricuspid E/A ratios, Tricuspid annular plane systolic excursion (TAPSE), Fractional area change (FAC), TDI velocities, and RV output. PDA and patent foramen ovale (PFO) flow and characteristics will be evaluated. TTEs followed a standardized protocol, performed by trained fellows and reviewed with neonatologists with hemodynamic expertise and pediatric cardiologists. Demographic and clinical data will be gathered, and echocardiographic measurements will be averaged over three cardiac cycles. Data are securely stored in a de-identified, password-protected database. Enrollment target is 40 participants; 20 are currently enrolled. Descriptive statistics will summarize baseline characteristics, Analysis of variance or Kruskal wallis will analyze echo parameters over time. Enrollment is still ongoing and will complete data analysis by March 2025