Non-invasive left ventricular myocardial work indices in preterm neonates born to mothers with severe preeclampsia in pregnancy.

Abstract

Objective: The study utilized non-invasive myocardial work indices to investigate myocardial injury in infants born to mothers with severe preeclampsia (SPE) and to explore the duration of this myocardial damage during the neonatal period.

Methods: This prospective study included 34 preterm infants born to mothers with SPE and 28 preterm infants born to mothers without severe pregnancy complications (termed "controls"). Echocardiography was performed in infants within 24 h of birth, then again at 48-72 h and 14-28 days, to obtain echocardiographic parameters. Two-dimensional speckle-tracking echocardiography (2D STE) was performed to construct a non-invasive left ventricular pressure-strain loop based on two-dimensional myocardial strain and non-invasive left ventricular systolic pressure measurements, allowing for the calculation of myocardial work indices.

Results: Within 24 h after delivery, left ventricular stroke volume (SV), cardiac output (CO), and left ventricular global work index (GWI) in newborns born of mothers with SPE were significantly reduced compared to controls, while mitral E/e' and left ventricular longitudinal strain were increased. At 48-72 h after birth, mitral E/e' and left ventricular global waste work (GWW) increased, and global work efficiency (GWE) was reduced in infants of mothers with SPE. During the 14-28 days of the neonatal period, left ventricular SV and CO were reduced in the offspring of mothers with SPE and mitral E peak velocity, and E/e' and left ventricular GWW were increased.

Conclusion: The adverse intrauterine environment caused by SPE can lead to persistent impaired left ventricular function in preterm infants during the neonatal period.