Newborns with a Congenital Heart Defect and Diastolic Steal Have an Altered Cerebral Arterial Doppler Profile - 17/06/23
Abstract |
Objectives |
To compare trends in the anterior cerebral artery (ACA) Doppler markers of vascular flow for neonates with a congenital heart defect (CHD) with and without diastolic systemic steal during the first 7 days of life.
Methods |
Prospective study recruiting newborns (≥35 weeks of gestation) with a CHD. Doppler ultrasound and echocardiography were performed daily from day 1 to 7. The cohort was divided into the presence/absence of holo-diastolic retrograde flow in the postductal aorta (“retrograde”) on the last-available echocardiogram. Data extractors were masked to retrograde status. Mixed effect models (random slope/intercept) were constructed using RStudio.
Results |
We enrolled 38 neonates with CHD. Retrograde aortic flow was present on the last echocardiogram in 23 (61%). Peak systolic velocity and mean velocity increased significantly over time, independent of retrograde status. However, having a “retrograde” flow status conferred a significant decrease over time of their ACA–end-diastolic velocity (β = –5.75 cm/s, 95% CI −8.38 to −3.12, P < .001, when compared with the nonretrograde group), and a significant increase in the ACA resistive (β = 0.16, 95% CI 0.10-0.22, P < .001) and pulsatility (β = 0.49, 95% CI 0.28-0.69, P < .001) indexes. No subject presented retrograde diastolic flow in the ACA.
Conclusions |
In neonates with CHD in the first week of life, infants with echocardiographic signs of systemic diastolic steal within the pulmonary circulation have Doppler signs of cerebrovascular steal in the ACA.
Le texte complet de cet article est disponible en PDF.Keywords : cerebral Doppler, anterior cerebral artery, congenital heart disease, neonate
Abbreviations : ACA, CHD, EDV, ICC, MRI, PGE, PSV, PVR, RI, Vm, VTI
Plan
| Just-for-Kids Foundation provided the funds to obtain the echocardiography machine and the Tomtec software for analysis. The Department of Pediatrics of McGill University provided funds to support this research. Division of Neonatology of the Montreal Children’s Hospital provided funds to support this research. The authors have no conflicts of interest to disclose. |
Vol 257
Article 113369- juin 2023 Retour au numéro
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