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Myocardial Work for Dynamic Monitoring of Myocardial Injury in Neonatal Asphyxia

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Abstract

To assess the value of parameters of myocardial work for dynamic monitoring of myocardial injury after neonatal asphyxia. Fifty-three neonates with asphyxia admitted within 24 h after delivery were divided into a mild asphyxia group (n = 40) and severe asphyxia group (n = 13). Echocardiography was performed within 24 h post-birth, within 72 h post-birth (48 h after first echo), and during recovery. The left ventricular ejection fraction on M-mode echocardiography and by Simpson’s biplane method (LVEF and Bi-EF, respectively), stroke volume (SV), cardiac output (CO), cardiac index (CI), global longitudinal strain (GLS), global work index (GWI), global constructive work (GCW), and other parameters were measured. Echocardiographic indicators were compared between groups and over time. GWI was significantly increased at 72 h in the mild asphyxia group (P < 0.05) but showed no significant change over time in the severe asphyxia group (P > 0.05). While GCW increased significantly over time in both groups (P < 0.05), it increased earlier in the mild asphyxia group. Time and grouping factors had independent effects on GWI and GCW (P > 0.05). The characteristics of differences in GWI and GCW between the two groups were different from those for LVEF, Bi-EF, SV, CO, CI, and GLS and their change characteristics with improvement from treatment. GWI and GCW changed significantly during recovery from neonatal asphyxia, and their change characteristics differed between mild and severe asphyxia cases. Myocardial work parameters can be used as valuable supplements to traditional indicators of left ventricular function to dynamically monitor the recovery from myocardial injury after neonatal asphyxia.

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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.

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Acknowledgements

This work was supported by the Gusu Health Talent Foundation [Grant Numbers GSWS2020054; GSWS2019048] and the Suzhou Science and Technology Bureau Science and Technology Development Plan [Grant Number SS2020066].

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Authors and Affiliations

  1. Department of Cardiology, Children’s Hospital of Soochow University, 92 Zhongnan Road, Suzhou, 215003, Jiangsu, China

    Xin-Lu Hu, Cui Hou, Hui Wang, Jun-Cheng Ni, Yue-Yue Ding, Xue-Ying Si, Xiao-Chen Li & Qiu-Qin Xu

  2. Department of Neonatology, Children’s Hospital of Soochow University, Suzhou, Jiangsu, China

    Hong Li & Tao Pan

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  1. Xin-Lu Hu
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  2. Cui Hou
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  3. Hui Wang
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Contributions

X-LH: Conceptualization, Methodology, Writing- Original draft preparation. CH: Data curation. HW: Formal analysis. HL, TP: Supervision, Resources. J-CN, Y-YD: Software, Validation. X-YS, X-CL: Visualization, Investigation. Q-QX: Writing- Reviewing and Editing, Funding acquisition, Project administration.All authors reviewed the manuscript.

Corresponding author

Correspondence to Qiu-Qin Xu.

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The authors declare no competing interests.

Ethical Approval

This study was approved by the Ethics Committee of Children’s Hospital of Soochow University (2021CS151).

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Informed consent was obtained from legal guardians and the study protocol conforms to the ethical guidelines of the 1975 Declaration of Helsinki as reflected in a priori approval by the institution's human research committee.

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Hu, XL., Hou, C., Wang, H. et al. Myocardial Work for Dynamic Monitoring of Myocardial Injury in Neonatal Asphyxia. Pediatr Cardiol (2023). https://doi.org/10.1007/s00246-023-03357-w

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