The evaluation of cardiac functions with tissue Doppler imaging, strain and strain rate measurement in newborns and infants

ObjectivesThe aim of this study was to establish of cardiac hemodinamic alternation in healty newborns and infants and determination of referance values in this period with tissue Doppler, strain and strain rate echocardiograpy.Material and methodsThe study was conducted in Malatya İnönü University Pediatric Cardiology Department between October 2010 and April 2011. 149 healty babies who following newborn unit and diagnosed as innocent murmur in Pediatric Cardiology Department, aging between 1 day and 3 months were included in this study. Cases were recruited into four groups: thirty two healty preterm infants (36-37 weeks of gestational age, group 1), thirty two healty term infants (? 38 weeks of gestational age, group 2), fourty seven healty infants (1 month of postnatal age, group 3) and, thirty eight healty infants (3 month of postnatal age, group 4).Standart echocardiographic evaluations, PW Doppler, tissue Doppler and strain, strain rate study were applied by same person using a MyLab50 echo machine (Esaote, Florence).ResultsStudy groups consisted; group 1: 18 (%56,3) female, 14 (% 43,8) male, group 2: 14 (%43,8) female, 18 (%56,3) male,. group 3: 18 (%33,8) female, 29 (%61,7) male and group 4 consisted 22 (%57,9) female, 16 (%42,1) male healthy children. No statistical significance were detected for apgar scores between the groups. (p>0.05)Systolic and diastolic functions by evaluated conventional echocardiography were normal in all groups. No statistical significance were detected for EF and FS between the groups. (p>0.05)Early diastolic mitral E and late diastolic mitral A velocities determined by pulsed wave doppler echocardiography for the left ventricle were increased from group 1 to group 2 (respectively p=0.02; p=0.004), from group 2 to group 3 (respectively p=0.001; p=0.001), from group 2 to group 4 (respectively p=0.001; p=0.01;), from group 1 to group 3 (respectively p<0.001; p<0.001), and from group 1 to group 4 (respectively p=0.001; p=0.001) The ratio of E/A was found higher in group 4 than group 2 (p= 0.005). No statistical significance were detected for the ratio of E/A between other groups. (p>0.05).Peak ealy relaxation velocity (E?) determined by tissue doppler echocardiography for the left ventricle was increased from group 1 to group 4. This increasing was found significant statistically between group 2 and group 3 (p=0.001), group 2 and group 4 (p=0.001), group 3 and group 4 (p=0.001), group 1 and 3 (p=0.001), and group 1 and group 4 (p=0.001). Peak late relaxation velocity (A?) determined by tissue Doppler echocardiography for the left ventricle was increased significantly from group 2 to group 3 (p=0.005), from group 1 to 3 (p=0.001) and, from group 1 to 4 (p=0.001)The longitidunal velocity, strain and SR values derivated from left ventricle apikal four chamber, two chamber and three chamber images, and circumfrencial velocity, strain and SR values derivated from left ventricle short axis images decreased from base to apex in all subjects (p<0.001). .ConclusionBased on our study findings, significant cardiac hemodynamic alterations have been occured during the newborn and early infancy period and this alteration could be detected by tissue doppler, strain and SR echocardiography. However, only few studies have been made, it is thought that more studies needs to be done on this issue.