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1.
J Pediatr ; 261: 113585, 2023 10.
Article in English | MEDLINE | ID: mdl-37354991

ABSTRACT

We evaluated the association between left cardiac 3-dimensional echocardiographic parameters and brain injury in a single-center prospective study of neonates with neonatal encephalopathy. On day 2 of life, neonates with brain injury had greater left ventricle end-diastolic and stroke volume but also greater peak global circumferential strain detected by 3-dimensional echocardiogram.


Subject(s)
Brain Injuries , Echocardiography, Three-Dimensional , Ventricular Dysfunction, Left , Infant, Newborn , Humans , Infant , Ventricular Function, Left , Prospective Studies , Echocardiography/methods , Echocardiography, Three-Dimensional/methods , Stroke Volume , Heart Ventricles/diagnostic imaging , Brain Injuries/complications , Brain Injuries/diagnostic imaging , Ventricular Dysfunction, Left/diagnostic imaging
2.
J Pediatr ; 257: 113369, 2023 06.
Article in English | MEDLINE | ID: mdl-36868306

ABSTRACT

OBJECTIVES: To compare trends in the anterior cerebral artery (ACA) Doppler markers of vascular flow for neonates with a congenital heart defect (CHD) with and without diastolic systemic steal during the first 7 days of life. METHODS: Prospective study recruiting newborns (≥35 weeks of gestation) with a CHD. Doppler ultrasound and echocardiography were performed daily from day 1 to 7. The cohort was divided into the presence/absence of holo-diastolic retrograde flow in the postductal aorta ("retrograde") on the last-available echocardiogram. Data extractors were masked to retrograde status. Mixed effect models (random slope/intercept) were constructed using RStudio. RESULTS: We enrolled 38 neonates with CHD. Retrograde aortic flow was present on the last echocardiogram in 23 (61%). Peak systolic velocity and mean velocity increased significantly over time, independent of retrograde status. However, having a "retrograde" flow status conferred a significant decrease over time of their ACA-end-diastolic velocity (ß = -5.75 cm/s, 95% CI -8.38 to -3.12, P < .001, when compared with the nonretrograde group), and a significant increase in the ACA resistive (ß = 0.16, 95% CI 0.10-0.22, P < .001) and pulsatility (ß = 0.49, 95% CI 0.28-0.69, P < .001) indexes. No subject presented retrograde diastolic flow in the ACA. CONCLUSIONS: In neonates with CHD in the first week of life, infants with echocardiographic signs of systemic diastolic steal within the pulmonary circulation have Doppler signs of cerebrovascular steal in the ACA.


Subject(s)
Cerebrovascular Circulation , Heart Defects, Congenital , Infant , Infant, Newborn , Humans , Prospective Studies , Blood Flow Velocity , Heart Defects, Congenital/diagnostic imaging , Ultrasonography, Doppler
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