Hostname: page-component-586b7cd67f-rdxmf Total loading time: 0 Render date: 2024-11-24T14:58:39.727Z Has data issue: false hasContentIssue false

A serial Doppler echocardigraphic study of early diastolic right ventricular events in full term neonates

Published online by Cambridge University Press:  19 August 2008

Jose C. Areias
Affiliation:
Departments of Pediatrics and Physiology, University of Porto, Porto, Portugal1
William A. Scott
Affiliation:
Department of Pediatrics and Children's Research Center, University of Arizona, Tucson2
Robin Meyer
Affiliation:
Department of Pediatrics and Children's Research Center, University of Arizona, Tucson2
Stanley J. Goldberg*
Affiliation:
Department of Pediatrics and Children's Research Center, University of Arizona, Tucson2
*
Dr. Stanley J. Goldberg, Department of Pediatrics (Cardiology), Arizona Health Sciences Center, 1501 N. Campbell Avenue, Tucson, AZ 85724, USA. Telephone: (602) 626–7482; facsimile: (602) 626–6571

Summary

Our purpose was to study serially, measurements which relate to right ventricular events, using echocardiography and Doppler in full term neonates for the first three weeks after birth. Echocardiographic and pulsed Doppler studies were performed for 21 newborns during the first 36 hours of life, and subsequent serial studies were performed in the second (n=21) and third (n=14) weeks of life. Evaluation included measurement of right isovolumic relaxation time and peak E and A velocities across the tricuspid valve. Pulmonary velocities were studied for evidence of patency of the arterial duct, and to determine acceleration in the pulmonary trunk. Mean right isovolumic relaxation time decreased significantly from 68±9 ms to 39 ± 14 ms (p<0.001) between the first and second week. Mean tricuspid peak E increased significantly between the second (48 ± 7 cm/s) and the third week of life (62 ± 8 cm/s; p<0.001). Mean peak A wave velocity did not change significantly during the time of study. The pulmonary arterial acceleration time increased from the initial measurement (68 ± 10 ms) to the second week (85 ± 9 ms; p<0.001). Changes in right isovolumic relaxation time were significantly related to the changes in the pulmonary arterial acceleration time (r=0.63, p=0.0001), suggesting a significant influence of afterload on diastolic events. These data demonstrate the normal progression of some measures of early right ventricular diastolic function.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 1992

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Rudolph, AM. Distribution and regulation of blood flow in the fetal and neonatal lamb. Circ Res 1985; 57: 811821.Google Scholar
2.King, ME, Braun, H, Goldblatt, A, Liberthson, R, Weyman, AE. Interventricular septal configuration as a predictor of right ventricular systolic hypertension in children: A cross-sectional echocardiographic study. Circulation 1983; 68: 6875.CrossRefGoogle ScholarPubMed
3.Bove, M, Santamore, WP. Ventricular interdependence. Prog Cardiovasc Dis 1981; 23: 365388.CrossRefGoogle ScholarPubMed
4.Ross, J. Acute displacement of the diastolic pressure-volume curve of the left ventricle: Role of the pericardium and the right ventricle. Circulation 1979; 59: 3237.CrossRefGoogle ScholarPubMed
5.Rein, AJJT, Sanders, SP, Colan, SD, Parness, IA, Epstein, M. Left ventricular mechanics in the normal newborn. Circulation 1987; 76: 10291036.Google Scholar
6.Anderson, PAW. Immature Myocardium. In: Moller, JH, Neal, WA (eds). Fetal, Neonatal and Infant Cardiac Disease. Appleton & Lange, Norwalk, Connecticut, 1990, pp 3571.Google Scholar
7.Gentile, R, Stevenson, JG, Dooley, T, Franklin, D, Kawabori, I, Pearlman, A. Pulsed Doppler echocardiographic determination of time of ductal closure in normal newborn infants. J Pediatr 1981; 98: 443448.CrossRefGoogle ScholarPubMed
8.Marx, GR, Allen, HD, Goldberg, SJ, Flinn, CJ. Transatrial septal velocity measurement by echocardiography in atrial septal defect: Correlation with QP:QS ratio. Am J Cardiol 1985; 55: 11621167.Google Scholar
9.Goldberg, SJ, Allen, HD, Marx, GR, Donnerstein, RL (eds). Doppler Echocardiography. Lea & Febiger, Philadelphia, 1988, p. 52.Google Scholar
10.Brutsaert, DL, Rademakers, FE, Sys, SU. Triple control of relaxation: Implications in cardiac disease. Circulation 1984; 69: 190196.Google Scholar
11.Reed, KL, Sahn, DJ, Scagnelli, SA, Anderson, CF, Shenker, L. Doppler echocardiographic studies of diastolic function in the human fetal heart: changing during gestation. J Am Col Cardiol 1986; 8: 391395.CrossRefGoogle ScholarPubMed
12.Riggs, TW, Rodríguez, R, Snider, AR, Batton, D. Doppler echocardiographic evaluation of right and left ventricular diastolic function in normal neonates. J Am Col Cardiol 1989; 13: 700705.Google Scholar
13.Wilson, N, Reed, KL, Allen, HD, Marx, GR, Goldberg, SJ. Doppler echocardiographic observations of pulmonary and transvalvular velocity changes after birth and during the early neonatal period. Am Heart J 1987; 113: 750758.CrossRefGoogle ScholarPubMed
14.Taylor, RR, Covell, JW, Sonnenblick, EH, Ross Jr, J. Dependence of ventricular distensibility on filling of the opposite ventricle. Am J Physiol 1967; 213: 711718.Google Scholar
15.Laks, MM, Gamer, D, Swan, HJC. Volumes and compliances measured simultaneously in the right and left ventricles of the dog. Circ Res 1967; 20: 565569.Google Scholar
16.Gaasch, WH, Zile, MR, Blaustein, AS, Bing, OHL. Loading conditions and left ventricular relaxation. In: Grossman, W, Lorrel, BH (eds). Diastolic Relaxation of the Heart. Martinus Nijhoff Publishing, Boston, 1989, pp 133142.Google Scholar
17.Snider, AR, Gidding, SS, Rocchini, AP, Rosenthal, A, Dick, M, Crowley, DC, Peters, J. Doppler evaluation of left ventricular diastolic filling in children with systemic hypertension. Am J Cardiol 1985; 56: 921926.Google Scholar
18.Appleton, CP, Hatle, LK, Popp, R. Relation of transmitral flow velocity patterns to left ventricular diastolic function: New insights from a combined hemodynamic and Doppler echocardiographic study. J Am Col Cardiol 1988; 12: 426440.Google Scholar
19.Kitabatake, A, Inoue, M, Asao, M, Masuyama, T, Tanouchi, J, Morita, T, Mishima, M, Uematsu, M, Shimazu, T, Hori, M, Abe, H. Noninvasive evaluation of pulmonary hypertension by a pulsed Doppler technique. Circulation 1983; 68: 302309.Google Scholar
20.Kosturakis, D, Goldberg, SJ, Allen, HD, Loeber, C. Doppler echocardiographic prediction of pulmonary arterial hypertension in congenital heart disease. Am J Cardiol 1984; 53: 11101115.CrossRefGoogle ScholarPubMed
21.Appleton, CP, Hatle, LK, Popp, RL. Demonstration of restrictive ventricular physiology by Doppler echocardiography. J Am Col Cardiol 1988; 11: 757768.CrossRefGoogle ScholarPubMed
22.Holmgren, SM, Goldberg, SJ, Donnerstein, RL. Factors which affect left ventricular diastolic indices in young subjects. Clin Res 1991; 39: 78A.Google Scholar