J Korean Med Sci.  2018 May;33(22):e155. 10.3346/jkms.2018.33.e155.

Chronological Echocardiographic Changes in Healthy Term Neonates within Postnatal 72 Hours Using Doppler Studies

• Ha KS
• Choi BM
• Lee EH
• Shin J
• Cho HJ
• Jang GY
• Son CS

• KMID: 2411886
• DOI: http://doi.org/10.3346/jkms.2018.33.e155

Abstract

BACKGROUND
This study evaluated echocardiographic changes in full-term healthy neonates during early transitional period from postnatal 0-72 hours at 12-hour intervals by echocardiography.
METHODS
This was a prospective, observational, and longitudinal single-center cohort study. Morphometric, functional, systolic, diastolic, and tissue Doppler imaging (TDI) parameters (patent ductus arteriosus [PDA], aorta, superior vena cava [SVC], stroke volume [SV], cardiac output [CO], cardiac index [CI], early diastolic flow velocity [E], late diastolic flow velocity [A], early filling in TDI [E"²], peak systolic annular velocity in TDI [S"²], late velocity peak in TDI [A"²], and myocardial performance index [MPI]) were evaluated in left ventricle (LV) and right ventricle (RV) with 56 newborns.
RESULTS
Sizes and peak velocities of PDA before postnatal 24 hours were significantly changed than those after postnatal 24 hours. Aortic velocity time integral (VTI), systolic blood pressure (BP), LV SV/kg, LV CO/kg, LV CI, and SVC flow/LV CO before 24 hours showed significantly changes than those after 24 hours. Also, LV and RV MPI before 24 hours were significantly higher than those after 24 hours. LV E/E"² was significantly higher than RV E/E"².
CONCLUSION
Postnatal 24 hours is critical time for hemodynamic closure of PDA because aortic VTI, systolic BP, LV SV, LV CO, LV CI, and SVC flow/LV CO showed simultaneously significant changes after 24 hours at the same time as 24 hours of physiological closure of PDA. Chronological and dramatic changes of systolic, diastolic, and TDI parameters during early postnatal period can be used to compile normal baseline data of healthy full-term neonates.

Keyword

Doppler; Echocardiography; Neonate; Term Birth

MeSH Terms

Aorta
Blood Pressure
Cardiac Output
Cohort Studies
Ductus Arteriosus
Echocardiography*
Heart Ventricles
Hemodynamics
Humans
Infant, Newborn*
Prospective Studies
Stroke Volume
Term Birth
Vena Cava, Superior