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Longitudinal strain and strain rate by tissue Doppler are more sensitive indices than fractional shortening for assessing the reduced myocardial function in asphyxiated neonates

Published online by Cambridge University Press:  06 October 2010

Eirik Nestaas ,
Asbjørn Støylen ,
Leif Brunvand  and
Drude Fugelseth
Eirik Nestaas*
Affiliation:
Department of Paediatrics, Oslo University Hospital, Ulleval, Oslo, Norway Department of Paediatrics, Vestfold Hospital Trust, Tønsberg, Norway
Asbjørn Støylen
Affiliation:
Department of Cardiology, St. Olavs Hospital, Trondheim, Norway Faculty of Medicine, Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
Leif Brunvand
Affiliation:
Department of Paediatrics, Oslo University Hospital, Ulleval, Oslo, Norway
Drude Fugelseth
Affiliation:
Department of Paediatrics, Oslo University Hospital, Ulleval, Oslo, Norway Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Blindern, Oslo, Norway
*
Correspondence to. Dr E. Nestaas, Department of Paediatrics, Vestfold Hospital Trust, 3103 Tønsberg, Norway. Tel: +47 333 42 000; Fax: +47 333 43 975; E-mail: nestaas@hotmail.com
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Abstract

The function of the heart was studied in 20 asphyxiated term neonates by measuring the longitudinal peak systolic strain and peak systolic strain rate by tissue Doppler in 18 segments of the heart on days 1, 2, and 3 of life. The fractional shortening was assessed at each examination as well. Measurements were compared against measurements in 48 healthy term neonates examined by the same protocol. The function of the heart was lower in the asphyxiated neonates – peak systolic strain (mean (95% confidence interval) −19.4% (−20.4, −18.5), peak systolic strain rate −1.65 (−1.74, −1.56) per second) than in the healthy term neonates (peak systolic strain −21.7% (−22.3, −21.0), peak systolic strain rate −1.78 (−1.84, −1.74) per second; p < 0.001). Fractional shortening was similar in the asphyxiated (29.2% (26.8, 31.5)) and healthy term neonates (29.0% (27.9, 30.1); p = 0.874). The peak systolic strain differed significantly between the asphyxiated and healthy term neonates for the left basal and right basal groups of segments (p < 0.05) but not for the left apical, right apical, septum apical, or septum basal groups of segments. The peak systolic strain rate differed significantly only for the septum apical group of segments. The differences were largest on the second day of life. Measurements were similar in asphyxiated neonates with elevated and normal cardiac troponin T levels. The peak systolic strain and strain rate were in this study more sensitive indices than fractional shortening for assessing the reduced myocardial function in asphyxiated term neonates.

Keywords

Myocardial contractioncardiovascular systemhypoxic–ischaemic insultischaemiaasphyxiadeformation
Type
Original Articles
Information
Cardiology in the Young , Volume 21 , Issue 1 , February 2011 , pp. 1 - 7
Copyright
Copyright © Cambridge University Press 2010

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