Myocardial perfusion and function dichotomy in growth restricted preterm infants
| العنوان: | Myocardial perfusion and function dichotomy in growth restricted preterm infants |
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| المؤلفون: | Arvind Sehgal, Beth J. Allison, Suzanne L. Miller, Graeme R. Polglase |
| المصدر: | Journal of Developmental Origins of Health and Disease. 14:302-310 |
| بيانات النشر: | Cambridge University Press (CUP), 2022. |
| سنة النشر: | 2022 |
| مصطلحات موضوعية: | Medicine (miscellaneous) |
| الوصف: | Compared to preterm appropriate for gestational age (AGA) fetuses, fetuses with fetal growth restriction (FGR) have earlier visualisation of coronary artery blood flow (CABF) but impaired cardiac function. This dichotomy remains uncharacterised during postnatal life. This study compared CABF and cardiac function in preterm FGR infants, against AGA infants during the postnatal period. FGR was defined as birthweight < 10th centile for gestation and sex with absent/reversed antenatal umbilical artery Doppler. Diastolic CABF was measured in the left anterior descending coronary artery. Twenty-eight FGR infants were compared with 26 AGA infants (gestation and birthweight, 29.7 ± 1.3 vs 29.9 ± 1 weeks, P = 0.6 and 918 ± 174 vs 1398 ± 263g, P < 0.001, respectively). Echocardiography was performed in the second week of life. FGR infants had higher CABF (velocity time integral, 2.4 ± 0.9 vs 1.6 ± 0.8 cm, P = 0.002). Diastolic function was impaired (↑ trans-mitral E/A ratio in FGR infants; 0.84 ± 0.05 vs 0.79 ± 0.03, P = 0.0002) while the systolic function was also affected (mean velocity of circumferential fibre shortening [mVCFc], 1.9 ± 0.3 vs 2.7 ± 0.5 circ/s, P < 0.001). Indexing CABF to cardiac function noted significant differences between the groups (CABF: E/A [FGR vs AGA], 2.9 ± 1.1 vs 2.1 ± 1, P = 0.01 and CABF: mVCFc [FGR vs AGA], 1.3 ± 0.5 vs 0.6 ± 0.3, P < 0.001). Diastolic blood pressure (BP) was significantly higher, and CABF to diastolic BP ratio trended higher in FGR infants (30 ± 2 vs 25 ± 3 mmHg, P < 0.001 and 0.08 ± 0.03 vs 0.06 ± 0.03, P = 0.059, respectively). Greater CABF in FGR infants did not translate into better cardiac function. This dichotomy may be a persistent response to fetal hypoxaemia (fetal programming) and/or reflection of altered cardiac architecture. |
| تدمد: | 2040-1752 2040-1744 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::49a69bc5e1e9917ea235614c002fdab4Test https://doi.org/10.1017/s2040174422000630Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....49a69bc5e1e9917ea235614c002fdab4 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 20401752 20401744 |
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