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Evaluation of left ventricular volumes in the early neonatal period using three-dimensional echocardiography

Published online by Cambridge University Press:  29 July 2013

Hiroyuki Nagasawa
Hiroyuki Nagasawa*
Affiliation:
Department of Neonatology, Gifu Prefectural General Medical Center, Gifu, Japan
*
Correspondence to: H. Nagasawa, Department of Neonatology, Gifu Prefectural General Medical Center, 4-6-1 Noisshiki, Gifu, 500-8717, Japan. Tel: 81-58-246-1111; Fax: 81-58-247-3748; E-mail: hironag@ccn2.aitai.ne.jp
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Abstract

Background

Awareness about normal cardiac volumes in the neonatal period is very important for understanding the cardiac function; however, the small cardiac size of neonates makes it difficult to perform invasive examinations. Three-dimensional echocardiography is used to evaluate cardiac volumes in children. However, no studies using this method have examined left ventricular volumes in neonates during the early neonatal period.

Methods

The study group consisted of 255 normal neonates. Comparisons of the stroke volume calculated according to the velocity–time integral and Pombo method were made.

Results

The volumes in both end-diastole and end-systole and the stroke volume gradually decreased over time after birth. Participants with continuous a persistent ductus arteriosus flow had higher stroke volumes than those without persistent ductus arteriosus. The average end-diastolic volume per body surface area (m2) was 30.61 ml/m2 in boys and 29.80 ml/m2 in girls, whereas the ventricular end-systolic volume was 12.89 ml/m2 in boys and 12.80 ml/m2 in girls among the participants without persistent ductus arteriosus. The average stroke volume was 17.70 ml/m2 in boys and 17.00 ml/m2 in girls. Statistically significant gender differences were observed in the end-diastolic volume (p = 0.0053), stroke volume (p < 0.0001), and ejection fraction (p = 0.039). The cardiac index was calculated to be 2.04 L/minute/m2 in boys and 1.95 L/minute/m2 in girls, which was significantly lower than that calculated using the velocity–time integral and Pombo method (p < 0.0001).

Conclusions

Significant gender differences in the end-diastolic volume, stroke volume, and ejection fraction at birth were revealed. The cardiac index in the early neonatal period was found to be relatively smaller than what had previously been recognised.

Keywords

Left ventricleend-diastolic volumeend-systolic volumestroke volumenormal neonategender differences
Type
Original Articles
Information
Cardiology in the Young , Volume 24 , Issue 4 , August 2014 , pp. 685 - 693
Copyright
Copyright © Cambridge University Press 2013 

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