Diastolic ventricular function in persistent pulmonary hypertension of the newborn
BackgroundPersistent pulmonary hypertension of the newborn (PPHN) is usually considered a consequence of impaired pulmonary circulation. However, little is known regarding the role of cardiac dysfunction in PPHN. In this study, we hypothesized that the tolerance for pulmonary hypertension in newborn...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-06-01
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| Series: | Frontiers in Pediatrics |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fped.2023.1175178/full |
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| author | Kévin Le Duc Kévin Le Duc Kévin Le Duc Thameur Rakza Thameur Rakza Jean Benoit Baudelet Mohamed Riadh Boukhris Mohamed Riadh Boukhris Sébastien Mur Sébastien Mur Ali Houeijeh Ali Houeijeh Laurent Storme Laurent Storme Laurent Storme |
| author_facet | Kévin Le Duc Kévin Le Duc Kévin Le Duc Thameur Rakza Thameur Rakza Jean Benoit Baudelet Mohamed Riadh Boukhris Mohamed Riadh Boukhris Sébastien Mur Sébastien Mur Ali Houeijeh Ali Houeijeh Laurent Storme Laurent Storme Laurent Storme |
| author_sort | Kévin Le Duc |
| collection | DOAJ |
| description | BackgroundPersistent pulmonary hypertension of the newborn (PPHN) is usually considered a consequence of impaired pulmonary circulation. However, little is known regarding the role of cardiac dysfunction in PPHN. In this study, we hypothesized that the tolerance for pulmonary hypertension in newborn infants depends on the biventricular function. The aim of this study is to evaluate biventricular cardiac performance by using Tissue Doppler Imaging (TDI) in an healthy newborn infants with asymptomatic pulmonary hypertension and in newborn infants with PPHN.MethodsRight and left cardiac function were investigated using conventional imaging and TDI in 10 newborn infants with PPHN (“PPHN”) and 10 asymptomatic healthy newborn infants (“asymptomatic PH”).ResultsSystolic pulmonary artery pressure (PAP) as assessed by TDI and the mean systolic velocity of the right ventricular (RV) free wall were similar in both groups. The isovolumic relaxation time of the right ventricle at the tricuspid annulus was significantly longer in the “PPHN” than in the “asymptomatic PH” group (53 ± 14 ms vs. 14 ± 4 ms, respectively; p < 0.05). Left ventricular (LV) function was normal in both groups with a systolic velocity (S'LV) at the LV free wall groups (6 ± 0.5 cm/s vs. 8.3 ± 5.7 cm/s, p > 0.05).ConclusionThe present results suggest that high PAP with or without respiratory failure is not associated with altered right systolic ventricular function and does not affect LV function in newborn infants. PPHN is characterized by a marked right diastolic ventricular dysfunction. These data suggest that the hypoxic respiratory failure in PPHN results, at least in part, from diastolic RV dysfunction and right to left shunting across the foramen ovale. We propose that the severity of the respiratory failure is more related to the RV diastolic dysfunction than the pulmonary artery pressure. |
| first_indexed | 2024-03-13T03:11:03Z |
| format | Article |
| id | doaj.art-9cdb2e829e54473c82805f94ea736fcb |
| institution | Directory Open Access Journal |
| issn | 2296-2360 |
| language | English |
| last_indexed | 2024-03-13T03:11:03Z |
| publishDate | 2023-06-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pediatrics |
| spelling | doaj.art-9cdb2e829e54473c82805f94ea736fcb2023-06-26T12:11:15ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602023-06-011110.3389/fped.2023.11751781175178Diastolic ventricular function in persistent pulmonary hypertension of the newbornKévin Le Duc0Kévin Le Duc1Kévin Le Duc2Thameur Rakza3Thameur Rakza4Jean Benoit Baudelet5Mohamed Riadh Boukhris6Mohamed Riadh Boukhris7Sébastien Mur8Sébastien Mur9Ali Houeijeh10Ali Houeijeh11Laurent Storme12Laurent Storme13Laurent Storme14Department of Neonatology, Pôle Femme-Mère-Nouveau-Né, Hôpital Jeanne de Flandre, Centre Hospitalier Universitaire de Lille, Lille, FranceUniversity of Lille, CHU Lille, ULR 2694—METRICS: Évaluation des Technologies de Santé et des Pratiques Médicales, axe Environnement Périnatal et Santé, Lille, FranceCenter for Rare Disease Congenital Diaphragmatic Hernia, Jeanne de Flandre Hospital, Centre Hospitalier Universitaire de Lille, Lille, FranceDepartment of Neonatology, Pôle Femme-Mère-Nouveau-Né, Hôpital Jeanne de Flandre, Centre Hospitalier Universitaire de Lille, Lille, FranceCenter for Rare Disease Congenital Diaphragmatic Hernia, Jeanne de Flandre Hospital, Centre Hospitalier Universitaire de Lille, Lille, FranceDepartment of Pediatric Cardiology, Jeanne de Flandre Hospital, Centre Hospitalier Universitaire de Lille, Lille, FranceDepartment of Neonatology, Pôle Femme-Mère-Nouveau-Né, Hôpital Jeanne de Flandre, Centre Hospitalier Universitaire de Lille, Lille, FranceCenter for Rare Disease Congenital Diaphragmatic Hernia, Jeanne de Flandre Hospital, Centre Hospitalier Universitaire de Lille, Lille, FranceDepartment of Neonatology, Pôle Femme-Mère-Nouveau-Né, Hôpital Jeanne de Flandre, Centre Hospitalier Universitaire de Lille, Lille, FranceCenter for Rare Disease Congenital Diaphragmatic Hernia, Jeanne de Flandre Hospital, Centre Hospitalier Universitaire de Lille, Lille, FranceUniversity of Lille, CHU Lille, ULR 2694—METRICS: Évaluation des Technologies de Santé et des Pratiques Médicales, axe Environnement Périnatal et Santé, Lille, FranceDepartment of Pediatric Cardiology, Jeanne de Flandre Hospital, Centre Hospitalier Universitaire de Lille, Lille, FranceDepartment of Neonatology, Pôle Femme-Mère-Nouveau-Né, Hôpital Jeanne de Flandre, Centre Hospitalier Universitaire de Lille, Lille, FranceUniversity of Lille, CHU Lille, ULR 2694—METRICS: Évaluation des Technologies de Santé et des Pratiques Médicales, axe Environnement Périnatal et Santé, Lille, FranceCenter for Rare Disease Congenital Diaphragmatic Hernia, Jeanne de Flandre Hospital, Centre Hospitalier Universitaire de Lille, Lille, FranceBackgroundPersistent pulmonary hypertension of the newborn (PPHN) is usually considered a consequence of impaired pulmonary circulation. However, little is known regarding the role of cardiac dysfunction in PPHN. In this study, we hypothesized that the tolerance for pulmonary hypertension in newborn infants depends on the biventricular function. The aim of this study is to evaluate biventricular cardiac performance by using Tissue Doppler Imaging (TDI) in an healthy newborn infants with asymptomatic pulmonary hypertension and in newborn infants with PPHN.MethodsRight and left cardiac function were investigated using conventional imaging and TDI in 10 newborn infants with PPHN (“PPHN”) and 10 asymptomatic healthy newborn infants (“asymptomatic PH”).ResultsSystolic pulmonary artery pressure (PAP) as assessed by TDI and the mean systolic velocity of the right ventricular (RV) free wall were similar in both groups. The isovolumic relaxation time of the right ventricle at the tricuspid annulus was significantly longer in the “PPHN” than in the “asymptomatic PH” group (53 ± 14 ms vs. 14 ± 4 ms, respectively; p < 0.05). Left ventricular (LV) function was normal in both groups with a systolic velocity (S'LV) at the LV free wall groups (6 ± 0.5 cm/s vs. 8.3 ± 5.7 cm/s, p > 0.05).ConclusionThe present results suggest that high PAP with or without respiratory failure is not associated with altered right systolic ventricular function and does not affect LV function in newborn infants. PPHN is characterized by a marked right diastolic ventricular dysfunction. These data suggest that the hypoxic respiratory failure in PPHN results, at least in part, from diastolic RV dysfunction and right to left shunting across the foramen ovale. We propose that the severity of the respiratory failure is more related to the RV diastolic dysfunction than the pulmonary artery pressure.https://www.frontiersin.org/articles/10.3389/fped.2023.1175178/fullPPHNnewbornright ventricular performancediastolic dysfunctiontissue doppler imaging |
| spellingShingle | Kévin Le Duc Kévin Le Duc Kévin Le Duc Thameur Rakza Thameur Rakza Jean Benoit Baudelet Mohamed Riadh Boukhris Mohamed Riadh Boukhris Sébastien Mur Sébastien Mur Ali Houeijeh Ali Houeijeh Laurent Storme Laurent Storme Laurent Storme Diastolic ventricular function in persistent pulmonary hypertension of the newborn Frontiers in Pediatrics PPHN newborn right ventricular performance diastolic dysfunction tissue doppler imaging |
| title | Diastolic ventricular function in persistent pulmonary hypertension of the newborn |
| title_full | Diastolic ventricular function in persistent pulmonary hypertension of the newborn |
| title_fullStr | Diastolic ventricular function in persistent pulmonary hypertension of the newborn |
| title_full_unstemmed | Diastolic ventricular function in persistent pulmonary hypertension of the newborn |
| title_short | Diastolic ventricular function in persistent pulmonary hypertension of the newborn |
| title_sort | diastolic ventricular function in persistent pulmonary hypertension of the newborn |
| topic | PPHN newborn right ventricular performance diastolic dysfunction tissue doppler imaging |
| url | https://www.frontiersin.org/articles/10.3389/fped.2023.1175178/full |
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