Doppler parameters of myocardial dysfunction in very low birth weight infants

Preterm neonate is exposed to significant hemodynamic changes after delivery. Cardiac and extracardiac shunts, especially ductus arteriosus, play an important role in this process. Failure of postnatal adaptation and persistent patent ductus arteriosus (PDA) may lead to cardiac overload and circulatory failure with hypoperfusion of vital organs and in turn adversely affect the short-term and long-term morbidity and mortality of these patients. Newborns with very low birth weight are at highest risk, however the possibilities for diagnosing circulatory failure in this patient group are limited. Clinical presentation and physical examination are nonspecific and involve subjective measures. Functional echocardiography provides information on systolic and diastolic heart function as well as the possibility to measure cardiac output and superior vena cava flow (SVC flow). Much of what is known about ventricular function pertains to systole rather than diastole. Near infrared spectroscopy provides another noninvasive method, enabling the measurement of tissue oxygenation including that of the brain. Cerebral oxygenation can be measured by placing the probe on the head of the neonate. Further possibility to help diagnose circulatory system failure are biochemical markers, commonly used in diagnosing..