The association between patterns of early respiratory disease and diastolic dysfunction in preterm infants
Koert de Waal, Edward Crendal, Amy Chin-Yu Poon, Mariyam Shaya Latheef, Elias Sachawars, Thomas MacDougall, Nilkant Phad
Abstract
Abstract Background This study aims to determine the association between clinical patterns of early respiratory disease and diastolic dysfunction in preterm infants. Methods Preterm infants <29 weeks’ gestation underwent cardiac ultrasounds around day 7 and 14–21. Respiratory dysfunction patterns were classified as stable (ST), respiratory deterioration (RD) or early persistent respiratory dysfunction (EPRD) according to oxygen need. Diastolic dysfunction was diagnosed using a multi-parameter approach including left atrial strain (LAS R ) to help differentiate between cardiac or pulmonary pathophysiology. Results 98 infants (mean 27 weeks) were included. The prevalence of ST, RD and EPRD was 53%, 21% and 26% respectively. Diastolic dysfunction was more prevalent in the RD and EPRD groups with patent ductus arteriosus and significant growth restriction as risk factors. Not all infants with a PDA developed diastolic dysfunction. LAS R was lower in the EPDR group. Conclusion Respiratory dysfunction patterns are associated with diastolic dysfunction in preterm infants.