Assessing Cardiac Functions in Large for Gestational Age Infants using Tissue Doppler Imaging

Abstract

Objective: To assess cardiac functions of  large for gestational age (LGA) infants with no maternal gestational diabetes mellitus using tissue Doppler imaging (TDI).  

Methods: LGA infants of nondiabetic mothers and appropriate for gestational age (AGA) infants  were included in this study. Conventional echocardiography and tissue Doppler echocardiography were performed in all patients.

Results Totally 78 neonates, of these, 37 term LGA infants were in study group and 41  gestational-age matched AGA infants constituted the control group. The mean birth weight of LGA infants was 4175 ±249.4 g; AGA infants was 3317±183.9 g (p <0.001). Among left and right ventricle tissue Doppler parameters; Left ventricular Am velocity was significantly higher and Em/Am ratio was lower in LGA infants and right ventricular Em/Am ratio  and Em velocity was significantly lower in LGA infants compared to control group. Among tissue Doppler myocardial performance index parameters, LGA infants had significantly higher values than controls regarding left ventricular (p<.001), and right ventricular (p<.001) myocardial performance indices.

Conclusion  The results of our study suggest that term LGA infants  may have a predisposition for cardiac structural changes and diastolic dysfunction. TDI is a feasible technique in neonates that provides direct information on the myocardium, allowing analysis of both systolic and diastolic functions in one waveform. The addition of TDI to standard neonatal echocardiography may provide additional information on cardiac functions of LGA infants