Day-2 echocardiography and cardiovascular biomarkers measurements in neonates with hypoxic-ischemic encephalopathy with or without brain injury.

IF 2.4 3区医学 Q2 OBSTETRICS & GYNECOLOGY

Journal of Perinatology Pub Date : 2025-09-19 DOI:10.1038/s41372-025-02419-6

Anie Lapointe, Pia Wintermark, Emmanouil Rampakakis, Punnannee Wutthigate, Shiran Sara Moore, Jessica Simoneau, Gabriel Altit

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引用次数: 0

Abstract

Objective: To assess the association between day-2 cardiac function and brain injury in neonates with HIE undergoing therapeutic hypothermia.

Study design: A prospective single-center study (2016-2021) including neonates ≥36 weeks gestation with moderate to severe HIE treated with TH. Brain injuries were evaluated using MRI and a validated scoring system, and logistic regression identified cardiovascular predictors.

Results: Among 55 neonates, 33 (60%) had brain injuries. Day-2 ventricular dysfunction was found in 16 (29%). Neonates with brain injuries had higher gestational age, more severe aEEG patterns, and higher Sarnat scores. Significant predictors of brain injury included higher gestational age, severe initial aEEG patterns, and increased left ventricular strain. No significant differences were observed in standard echocardiography measurements.

Conclusion: Severe initial aEEG patterns and increased left ventricular strain, rather than day-2 cardiac dysfunction, were more predictive of brain injury in HIE neonates. Early assessments may further clarify the role of hemodynamics.

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新生儿缺氧缺血性脑病伴或不伴脑损伤的第2天超声心动图和心血管生物标志物测量

目的：探讨治疗性低温下新生儿HIE第2天心功能与脑损伤的关系。研究设计：一项前瞻性单中心研究（2016-2021年），纳入妊娠≥36周、接受TH治疗的中度至重度HIE新生儿。脑损伤评估使用MRI和一个有效的评分系统，并通过逻辑回归确定心血管预测因子。结果：55例新生儿中，脑损伤33例（60%）。16例（29%）出现第2天心室功能障碍。脑损伤的新生儿胎龄较高，aEEG模式较严重，Sarnat评分较高。脑损伤的重要预测因素包括胎龄高、严重的初始aEEG模式和左心室劳损增加。在标准超声心动图测量中没有观察到显著差异。结论：严重的初始aEEG模式和增加的左心室劳损，而不是第2天的心功能障碍，更能预测HIE新生儿的脑损伤。早期评估可以进一步明确血流动力学的作用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Perinatology 医学-妇产科学

CiteScore

5.40

自引率

6.90%

发文量

284

审稿时长

3-8 weeks

期刊介绍： The Journal of Perinatology provides members of the perinatal/neonatal healthcare team with original information pertinent to improving maternal/fetal and neonatal care. We publish peer-reviewed clinical research articles, state-of-the art reviews, comments, quality improvement reports, and letters to the editor. Articles published in the Journal of Perinatology embrace the full scope of the specialty, including clinical, professional, political, administrative and educational aspects. The Journal also explores legal and ethical issues, neonatal technology and product development. The Journal’s audience includes all those that participate in perinatal/neonatal care, including, but not limited to neonatologists, perinatologists, perinatal epidemiologists, pediatricians and pediatric subspecialists, surgeons, neonatal and perinatal nurses, respiratory therapists, pharmacists, social workers, dieticians, speech and hearing experts, other allied health professionals, as well as subspecialists who participate in patient care including radiologists, laboratory medicine and pathologists.