-
Pediatr Crit Care Me · May 2012
Myocardial dysfunction in neonatal sepsis: a tissue Doppler imaging study.
- Hesham E Abdel-Hady, Mohamed K Matter, and Mohamed M El-Arman.
- Neonatal Intensive Care Unit, Mansoura University Children's Hospital, Mansoura, Egypt. hehady@yahoo.com
- Pediatr Crit Care Me. 2012 May 1;13(3):318-23.
ObjectivesTo assess myocardial performance in septic full-term infants and to correlate it with serum cardiac troponin T concentrations.DesignProspective, case-control, clinical study.SettingNeonatal intensive care unit in a university hospital.PatientsTwenty septic and 20 nonseptic full-term neonates.InterventionsNone.Measurements And Main ResultsConventional echocardiography, tissue Doppler imaging, and serum cardiac troponin T concentration tests were performed as soon as diagnosis was made. On tissue Doppler imaging measurements, right ventricular and left ventricular Tei indexes were significantly higher in septic neonates compared to nonseptic neonates (mean ± SD: 0.51 ± 0.09 vs. 0.28 ± 0.05, p < .001, and 0.56 ± 0.07 vs. 0.39 ± 0.04, p < .001, respectively). Mitral and tricuspid peak annular systolic velocities were significantly lower in septic neonates (mean ± SD: 4.35 ± 0.68 vs. 6.89 ± 0.94 cm/sec, p < .0001, and 5.55 ± 0.66 vs. 6.69 ± 0.87 cm/second, p < .0001, respectively). On conventional echocardiography measurements, left ventricular internal diameter at end-diastole was significantly higher in septic neonates (p = .04), whereas cardiac index and left ventricular and right ventricular diastolic functions were not significantly different between septic and nonseptic neonates. Cardiac troponin T concentrations were significantly higher in septic neonates (median [range], 0.19 [0.12- 0.32] vs. 0.03 [0-0.07] mg/L, p < .0001), and they correlated positively with left ventricular Tei index (r = .80; p < .0001) and right ventricular Tei index (r = .73; p < .0001), and correlated negatively with mitral peak annular systolic velocity (r = -.70; p < .0001) and tricuspid peak annular systolic (r = -.39, p = .012). Nonsurvivors had significantly higher serum cardiac troponin T concentrations and left ventricular Tei index.ConclusionsNeonatal sepsis is associated with systolic and diastolic myocardial dysfunction. This study provides proof-of-concept data for the use of tissue Doppler imaging in assessment of myocardial dysfunction in septic neonates. Tissue Doppler imaging appears to be more sensitive than conventional echocardiography in the detection of this dysfunction. Serum cardiac troponin T and left ventricular Tei index may have prognostic value in these patients.
Notes
Knowledge, pearl, summary or comment to share?You can also include formatting, links, images and footnotes in your notes
- Simple formatting can be added to notes, such as
*italics*
,_underline_
or**bold**
. - Superscript can be denoted by
<sup>text</sup>
and subscript<sub>text</sub>
. - Numbered or bulleted lists can be created using either numbered lines
1. 2. 3.
, hyphens-
or asterisks*
. - Links can be included with:
[my link to pubmed](http://pubmed.com)
- Images can be included with:
![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
- For footnotes use
[^1](This is a footnote.)
inline. - Or use an inline reference
[^1]
to refer to a longer footnote elseweher in the document[^1]: This is a long footnote.
.