Echocardiographic measures of ventricular-vascular interactions in congenital diaphragmatic hernia.

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From: Early Human Development(Vol. 165)
Publisher: Elsevier B.V.
Document Type: Report
Length: 460 words

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Keywords Pulmonary artery acceleration time; Tricuspid annular plane systolic excursion Highlights * Echocardiographic measures of ventricular-vascular interactions are prognostic. * Early ( * Patent ductus arteriosus flow velocity time integral from right to left performed best. Abstract Objective To evaluate the utility of echocardiographic measures of ventricular-vascular interactions in predicting death or ECMO in congenital diaphragmatic hernia (CDH). Design In this single center retrospective study, early ( Results Our cohort (n = 58) comprised 34 (59%) males and predominantly (81%) left sided CDH. Of these, 34 (58.6%) infants died or received ECMO and 24 (41.4%) survived without ECMO. RVSP and PDA/RL VTI were higher, and RV TAPSE, PAAT/PET, TAPSE/PAAT and TAPSE/RVSP ratios were all significantly lower in the death/ECMO group. PDA/RLVTI ratio had the highest area under the curve (0.76); values [greater than or equal to] 0.6 had high specificity [88% (95% C.I. 62--98%)] and positive predictive value [88% (95% C.I. 65--96%)] for adverse outcomes. Conclusion(s) Novel early ECHO parameters which combine RV function and PH severity were found to be feasible and prognostic in CDH. A detailed non-invasive assessment of ventricular-vascular interactions is important for risk-stratification in this population. Abbreviations CDH, congenital diaphragmatic hernia; ECMO, extracorporeal membrane oxygenator; LV, left ventricle; RV, right ventricle; MPI, myocardial performance index; TAPSE, tricuspid annular plane systolic excursion; FAC, fractional area change; TRV, tricuspid regurgitant velocity; VTI, velocity time integral; PAAT, pulmonary artery acceleration time; PET, pulmonary ejection time; SD, systolic to diastolic ratio; PDA, patent ductus arteriosus; PFO, patent foramen ovale; NICU, Neonatal Intensive Care Unit Author Affiliation: (a) Department of Pediatrics, Central Michigan University, Mount Pleasant, MI, United States of America (b) Children's Hospital of Michigan, Detroit, MI, United States of America (c) Department of Pediatric Surgery, United States of America * Corresponding author at: Division of Neonatology, Children's Hospital of Michigan, 3901 Beaubien Blvd, Detroit, MI 48201, United States of America. Article History: Received 25 March 2021; Revised 14 December 2021; Accepted 20 December 2021 Byline: Sanjeev Aggarwal (a,b), Christina Shanti (b,c), Prashant Agarwal (a,b), Joseph Lelli (b,c), Girija Natarajan [] (a,b,*)

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Gale Document Number: GALE|A690390464