Improved Cardiac Performance with Dexamethasone Therapy in Premature Neonates: Novel Insights Using Serial Echocardiographic Assessments
(1) Background: dexamethasone is used for the prevention and treatment of chronic lung disease (CLD) in premature neonates, and its impact on cardiac performance and pulmonary vascular resistance has not been well studied. (2) Methods: eligible neonates of <30 weeks gestational age (GA) had echoc...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2023-10-01
|
| Series: | Applied Sciences |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2076-3417/13/20/11380 |
| _version_ | 1797574857324494848 |
|---|---|
| author | Jejelola Ladele Ayman Saker Talal Altamimi Andrea De La Hoz Renjini Lalitha Michael R. Miller Soume Bhattacharya |
| author_facet | Jejelola Ladele Ayman Saker Talal Altamimi Andrea De La Hoz Renjini Lalitha Michael R. Miller Soume Bhattacharya |
| author_sort | Jejelola Ladele |
| collection | DOAJ |
| description | (1) Background: dexamethasone is used for the prevention and treatment of chronic lung disease (CLD) in premature neonates, and its impact on cardiac performance and pulmonary vascular resistance has not been well studied. (2) Methods: eligible neonates of <30 weeks gestational age (GA) had echocardiograms performed on them at three time points—before the initiation of dexamethasone (Echo-1), 24–48 h post the completion of dexamethasone therapy (Echo-2), and 7–14 days after course completion (Echo-3). (3) Results: 28 neonates with a 25.2 week mean GA and 652.9 g birthweight were included. The mean cumulative dose of dexamethasone was 0.98 mg/kg, given over 8–10 days. Echo-1 and Echo-2 showed a significant improvement in the right ventricular fractional area change (RV FAC 44.88 vs. 49.71, <i>p</i> = 0.025), tricuspid annular plane systolic excursion (TAPSE 0.65 cm vs. 0.70 cm, <i>p</i> = 0.013), and RV S’ (7.18 vs. 8.56, <i>p</i> = 0.05). The left ventricular (LV) ejection fraction was similar but with a significant increase in the LV S’ (4.77 vs. 6.01, <i>p</i> = 0.006). A longitudinal analysis at three time points showed a significant increase in RV FAC (0.02 units 95% CI (0.00–0.04), <i>p</i> = 0.037), TAPSE (0.09 units 95% CI (0.06–0.13), <i>p</i> < 0.001), RV S’ (0.97 units (95% CI = 0.11–1.84), <i>p</i> = 0.028), a reduction in the eccentricity index (0.07 units 95% CI (−0.14–−0.01), <i>p</i> = 0.030), and an increase in the LV S’ (0.56 units (95% CI = 0.18–0.94)). (4) Conclusion: The use of postnatal dexamethasone for the prevention/treatment of CLD in premature neonates resulted in an expected improvement in respiratory status along with a significant improvement in the echocardiographic measures of biventricular heart performance. |
| first_indexed | 2024-03-10T21:28:02Z |
| format | Article |
| id | doaj.art-0e62a1c0cd3e4b518add60eaa7e40d6b |
| institution | Directory Open Access Journal |
| issn | 2076-3417 |
| language | English |
| last_indexed | 2024-03-10T21:28:02Z |
| publishDate | 2023-10-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Applied Sciences |
| spelling | doaj.art-0e62a1c0cd3e4b518add60eaa7e40d6b2023-11-19T15:31:25ZengMDPI AGApplied Sciences2076-34172023-10-0113201138010.3390/app132011380Improved Cardiac Performance with Dexamethasone Therapy in Premature Neonates: Novel Insights Using Serial Echocardiographic AssessmentsJejelola Ladele0Ayman Saker1Talal Altamimi2Andrea De La Hoz3Renjini Lalitha4Michael R. Miller5Soume Bhattacharya6Department of Pediatrics, Division of Neonatal Perinatal Medicine, Western University, London, ON N6A 3K7, CanadaDepartment of Pediatrics, Division of Neonatal Perinatal Medicine, Western University, London, ON N6A 3K7, CanadaDepartment of Pediatrics, Division of Neonatal Perinatal Medicine, Western University, London, ON N6A 3K7, CanadaDepartment of Lawson Research—Medicine, London Health Sciences Centre, London, ON N6A 5W, CanadaDepartment of Pediatrics, Division of Neonatal Perinatal Medicine, Western University, London, ON N6A 3K7, CanadaDepartment of Pediatrics, Division of Neonatal Perinatal Medicine, Western University, London, ON N6A 3K7, CanadaDepartment of Pediatrics, Division of Neonatal Perinatal Medicine, Western University, London, ON N6A 3K7, Canada(1) Background: dexamethasone is used for the prevention and treatment of chronic lung disease (CLD) in premature neonates, and its impact on cardiac performance and pulmonary vascular resistance has not been well studied. (2) Methods: eligible neonates of <30 weeks gestational age (GA) had echocardiograms performed on them at three time points—before the initiation of dexamethasone (Echo-1), 24–48 h post the completion of dexamethasone therapy (Echo-2), and 7–14 days after course completion (Echo-3). (3) Results: 28 neonates with a 25.2 week mean GA and 652.9 g birthweight were included. The mean cumulative dose of dexamethasone was 0.98 mg/kg, given over 8–10 days. Echo-1 and Echo-2 showed a significant improvement in the right ventricular fractional area change (RV FAC 44.88 vs. 49.71, <i>p</i> = 0.025), tricuspid annular plane systolic excursion (TAPSE 0.65 cm vs. 0.70 cm, <i>p</i> = 0.013), and RV S’ (7.18 vs. 8.56, <i>p</i> = 0.05). The left ventricular (LV) ejection fraction was similar but with a significant increase in the LV S’ (4.77 vs. 6.01, <i>p</i> = 0.006). A longitudinal analysis at three time points showed a significant increase in RV FAC (0.02 units 95% CI (0.00–0.04), <i>p</i> = 0.037), TAPSE (0.09 units 95% CI (0.06–0.13), <i>p</i> < 0.001), RV S’ (0.97 units (95% CI = 0.11–1.84), <i>p</i> = 0.028), a reduction in the eccentricity index (0.07 units 95% CI (−0.14–−0.01), <i>p</i> = 0.030), and an increase in the LV S’ (0.56 units (95% CI = 0.18–0.94)). (4) Conclusion: The use of postnatal dexamethasone for the prevention/treatment of CLD in premature neonates resulted in an expected improvement in respiratory status along with a significant improvement in the echocardiographic measures of biventricular heart performance.https://www.mdpi.com/2076-3417/13/20/11380preterm neonatesdexamethasoneechocardiogramschronic lung diseasecardiac performancepulmonary vascular resistance |
| spellingShingle | Jejelola Ladele Ayman Saker Talal Altamimi Andrea De La Hoz Renjini Lalitha Michael R. Miller Soume Bhattacharya Improved Cardiac Performance with Dexamethasone Therapy in Premature Neonates: Novel Insights Using Serial Echocardiographic Assessments Applied Sciences preterm neonates dexamethasone echocardiograms chronic lung disease cardiac performance pulmonary vascular resistance |
| title | Improved Cardiac Performance with Dexamethasone Therapy in Premature Neonates: Novel Insights Using Serial Echocardiographic Assessments |
| title_full | Improved Cardiac Performance with Dexamethasone Therapy in Premature Neonates: Novel Insights Using Serial Echocardiographic Assessments |
| title_fullStr | Improved Cardiac Performance with Dexamethasone Therapy in Premature Neonates: Novel Insights Using Serial Echocardiographic Assessments |
| title_full_unstemmed | Improved Cardiac Performance with Dexamethasone Therapy in Premature Neonates: Novel Insights Using Serial Echocardiographic Assessments |
| title_short | Improved Cardiac Performance with Dexamethasone Therapy in Premature Neonates: Novel Insights Using Serial Echocardiographic Assessments |
| title_sort | improved cardiac performance with dexamethasone therapy in premature neonates novel insights using serial echocardiographic assessments |
| topic | preterm neonates dexamethasone echocardiograms chronic lung disease cardiac performance pulmonary vascular resistance |
| url | https://www.mdpi.com/2076-3417/13/20/11380 |
| work_keys_str_mv | AT jejelolaladele improvedcardiacperformancewithdexamethasonetherapyinprematureneonatesnovelinsightsusingserialechocardiographicassessments AT aymansaker improvedcardiacperformancewithdexamethasonetherapyinprematureneonatesnovelinsightsusingserialechocardiographicassessments AT talalaltamimi improvedcardiacperformancewithdexamethasonetherapyinprematureneonatesnovelinsightsusingserialechocardiographicassessments AT andreadelahoz improvedcardiacperformancewithdexamethasonetherapyinprematureneonatesnovelinsightsusingserialechocardiographicassessments AT renjinilalitha improvedcardiacperformancewithdexamethasonetherapyinprematureneonatesnovelinsightsusingserialechocardiographicassessments AT michaelrmiller improvedcardiacperformancewithdexamethasonetherapyinprematureneonatesnovelinsightsusingserialechocardiographicassessments AT soumebhattacharya improvedcardiacperformancewithdexamethasonetherapyinprematureneonatesnovelinsightsusingserialechocardiographicassessments |