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Right Ventricular Function in Neonates During Early Postnatal Period: A Prospective Observational Study

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Abstract

Previous echocardiographic studies were mainly focused on preterm infants and early fetal-to-neonatal transition period, whereas little is known about changes in the parameters of the right ventricular (RV) function after 72 h of life. Our aim was to quantitatively characterize potential changes in RV function by echocardiography in healthy term newborns between the third and the seventh day of life. We conducted a prospective observational study in 35 full-term newborns, in whom we performed echocardiographic examinations on the third and the seventh day of life. We assessed RV function, output and afterload and found a significant increase in all tissue Doppler velocities as well as in RV longitudinal strain, a higher mean RV outflow tract velocity time integral and lower myocardial performance index (MPI'), whereas the tricuspid annular plane systolic excursion, RV filling pattern, and RV outflow tract acceleration time were not significantly different between the third and the seventh day of life. Conclusions: Increased RV systolic and diastolic myocardial velocities, cardiac output and longitudinal deformation and decreased RV MPI' between the third and the seventh day of life point to a reduction of RV afterload and adaptive myocardial maturation in term newborns during this period. Moreover, PW-TDI and 2D speckle-tracking echocardiography seem to be more sensitive for evaluating RV function in comparison with M-mode echocardiography and pulsed-wave Doppler analysis of RV filling.

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Data Availability

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

Code Availability

Not applicable.

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Acknowledgements

The authors would like to thank Dr. Marta Cvijić for her guidance on quantitative analysis of echocardiographic images and helpful advice in organizing and interpreting the results.

Funding

No funding was received in support of the study.

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Authors and Affiliations

  1. Department of Neonatology, Division of Pediatrics, University Medical Centre Ljubljana, Bohoričeva 20, 1000, Ljubljana, Slovenia

    Jerneja Peček & Petja Fister

  2. Unit of Cardiology, Division of Pediatrics, University Medical Centre Ljubljana, Ljubljana, Slovenia

    Mirta Koželj

  3. Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia

    Jerneja Peček, Mirta Koželj & Petja Fister

  4. Institute of Physiology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia

    Helena Lenasi

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Contributions

JP analyzed the data and contributed to its interpretation, drafted the initial manuscript, and prepared the manuscript for publication. MK and HL substantially contributed to interpretation of the findings and reviewed and critically revised the article for important intellectual content. PF conceptualized and designed the study, contributed to acquisition of data and substantively revised the article. All authors have approved the submitted version and agree to be accountable for all aspects of the work.

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Correspondence to Jerneja Peček.

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The authors declare that they have no financial or non-financial conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the national research committee (Republic of Slovenia National Medical Ethics Committee (0120–671/2017/9).) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from parents of all participating newborns included in the study.

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Peček, J., Koželj, M., Lenasi, H. et al. Right Ventricular Function in Neonates During Early Postnatal Period: A Prospective Observational Study. Pediatr Cardiol 43, 1327–1337 (2022). https://doi.org/10.1007/s00246-022-02855-7

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  • DOI: https://doi.org/10.1007/s00246-022-02855-7

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