Journal of the American Society of Echocardiography
Clinical InvestigationFetal and Pediatric EchocardiographySerial Assessment of Cardiac Function and Pulmonary Hemodynamics in Infants With Down Syndrome
Section snippets
Participants
This was a prospective, observational cohort study performed across 3 tertiary neonatal intensive care units of Dublin, Ireland, between July 2018 and March 2020: the Rotunda Hospital; the National Maternity Hospital, Holles Street; and the Coombe Women and Infants University Hospital. Each neonatal unit delivers 8,000 to 8,500 infants annually. All infants with an antenatal or postnatal (later confirmed with karyotyping) diagnosis of DS were eligible for inclusion. All potentially eligible
Clinical Outcomes of Infants With DS Over the First 2 Years of Age
One hundred thirty infants were enrolled into this study, comprising 70 infants with DS and 60 control infants. During the study period an estimated 113 infants were born with a diagnosis of DS. Twelve had a surgical comorbidity, 17 were not enrolled due to investigator unavailability, 7 were not approached at the attending neonatologist’s request, and 7 parents did not provide consent. Offline analysis was possible on all available echocardiograms from this cohort. The antenatal detection rate
Discussion
Our study demonstrates sustained abnormal elevation of surrogates of pulmonary pressures and impaired systolic and diastolic function in infants with DS compared with controls over the first 2 years of age. Surrogate indices of PH and myocardial performance are negatively impacted in babies with DS irrespective of structural cardiac disease. Infants with DS undergoing surgical repair exhibit additional impairment in LV and RV function. Infants with DS displayed shorter RV and LV lengths over
Conclusion
This study has demonstrated sustained abnormal elevation of surrogate markers of PH and impaired systolic and diastolic function in infants with DS compared with controls over the first 2 years of age. The observation that surrogate indices of PH and myocardial performance are negatively impacted in babies with DS irrespective of structural cardiac disease is a nuance that is missing in the currently available literature. Our work highlights that the DS infant population, who have an increased
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Conflicts of Interest: None.
This work received funding from the Health Research Board Ireland (NCHF-2017-005) and the National Children's Research Centre (D/17/7). The funding sources had no role in the design or conduct of the study; collection, management, analysis, or interpretation of the data; preparation, review, or approval of the manuscript; or decision to submit the manuscript for publication.