Korean Circ J.  2006 Sep;36(9):652-660. 10.4070/kcj.2006.36.9.652.

Echocardiographic Assessment of Left Ventricular Diastolic Function in Transitional Circulation Period

• Hong JS
• Choi JY
• Zhu L
• Lee JH
• Lim IS
• Chung YS
• Choi CW
• Park KH
• Suh CS
• Han ES

• KMID: 1895029
• DOI: http://doi.org/10.4070/kcj.2006.36.9.652

Abstract

BACKGROUND AND OBJECTIVES: During the transitional period from fetal to neonatal life, there are dramatic changes in the newborn circulation. Among these changes, the left ventricular diastolic function can be easily assessed by Doppler measurement of the mitral inflow. However, there are many physiologic and hemodynamic factors responsible for the mitral inflow. This study was designed to evaluate several parameters that represent the left ventricular function during the transitional circulation period.
SUBJECTS AND METHODS
Eighteen normal full-term infants were studied by serial two-dimensional, Doppler and color flow echocardiography within 24 hours before and after birth, between 2 days and 6 days after birth and between 7 days and 30 days after birth).
RESULTS
One day after birth, the mitral valve (MV) E velocity and E/A increased (37.9+/-7.5 vs. 60.3+/-9.0 and 0.8+/-0.1 vs. 1.1+/-0.1, p<0.01, respectively), but the MV A velocity, the velocity of propagation (Vp), the LV isovolumic relaxation time (IVRT), the corrected IVRT and the tissue Doppler ventricular septum e' and s' did not change. Although Vp/E and a' decreased (1.2+/-0.3 vs. 0.7+/-0.2 and 8.2+/-1.8 vs. 6.5+/-1.7, p<0.05, respectively), the E/e' and the systolic and diastolic pulmonary venous flow velocities increased after birth (6.3+/-1.9 vs. 11.6+/-2.9, and 26.1+/-6.7 vs. 64.5+/-9.6, and 20.9+/-4.1 vs. 63.5+/-17.2, p<0.05, respectively).
CONCLUSION
Increased preload plays a key role for the increased MV E/A ratio after birth. Other unknown factors (and possibly including pericardial restriction) may be also responsible for left ventricular diastolic function.

Keyword

Diastolic function

MeSH Terms

Echocardiography*
Echocardiography, Doppler, Color
Hemodynamics
Humans
Infant
Infant, Newborn
Mitral Valve
Parturition
Relaxation
Ventricular Function, Left
Ventricular Septum