A Comprehensive Echocardiographic Assessment of Neonatal Right Ventricular Function in Neonatal Intensive Care Unit Babies

Nikita Khot, Santosh Joshi, Sudhir Malwade, Sanjay Chavan, Shailaja V Mane, Sharad Agarkhedkar, Amodini Arora, Nikita Khot, Santosh Joshi, Sudhir Malwade, Sanjay Chavan, Shailaja V Mane, Sharad Agarkhedkar, Amodini Arora

Abstract

Background The right ventricle (RV) in the fetus is the predominant chamber, accounting for about 60% of the total cardiac output. The majority of the RV outflow volume is diverted from the pulmonary artery via the ductus arteriosus to the descending aorta. After birth, the RV undergoes extensive structural and functional modifications. The RV undergoes an improper transition from fetal to neonatal circulation in sick neonatal intensive care unit (NICU) babies. Functional echocardiography is now commonly being used in most NICUs as it is a noninvasive and bedside investigation that gives an immediate evaluation of hemodynamics and can be taken into consideration as an extension of clinical assessment to study a critically unwell neonate. Therefore, a study of RV functions in NICU neonates will help in better understanding the neonatal cardiopulmonary response to different diseases. Thus, this study aimed to assess RV functions in neonates getting admitted to the NICU of a tertiary care institute. Methodology This observational, cross-sectional study was approved by the Research & Recognition Committee of Dr. D. Y. Patil Vidyapeeth, Pune. In total, 35 cases of term neonates admitted to the NICU at Dr. D. Y. Patil Medical College, Hospital & Research Centre, Pune who fulfilled the inclusion criteria were enrolled in this study after obtaining consent from their parents. Two-dimensional echocardiography was performed by a trained pediatric cardiologist, and the findings were substantiated by a neonatologist trained in echocardiography. Results Our study found a strong association between tricuspid inflow velocity and neonates with sepsis. Similarly, a significant association was observed between abnormal tricuspid Inflow velocity (E/A and E/E') and neonates requiring inotropic support. Conclusions Data on the normal values of different echocardiographic parameters of the systolic and diastolic function of the RV during the neonatal phase of life are currently limited. Our data offer preliminary insights into this topic. Early echocardiography and intervention are advisable, especially in neonates with sepsis and requiring inotropic support.

Keywords: 2d echo; mpi; myocardial performance index; rv function; tapse; tricuspid annular plane systolic excursion; tricuspid inflow velocity.

Conflict of interest statement

The authors have declared that no competing interests exist.

Copyright © 2023, Khot et al.

Figures

Figure 1. Image shows the tricuspid inflow…
Figure 1. Image shows the tricuspid inflow velocity (E’) values.
Figure 2. M mode tracing showing tricuspid…
Figure 2. M mode tracing showing tricuspid annulus plane systolic excursion.
Figure 3. Imaging shows the tricuspid inflow…
Figure 3. Imaging shows the tricuspid inflow velocity (E/A) values of the tricuspid valve.

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