%0 Journal Article
%T Left atrial strain assessment unveils left ventricular diastolic dysfunction in neonates with transient tachypnea of the newborn: A prospective observational study.
%A Ficial B
%A Dolce P
%A Petoello E
%A Flore AI
%A Nogara S
%A Ciarcià M
%A Brancolini G
%A Alfarano A
%A Marzollo R
%A Bosio I
%A Raimondi F
%A Risso FM
%A Beghini R
%A Dani C
%A Benfari G
%A Ribichini FL
%A Corsini I
%J Pediatr Pulmonol
%V 0
%N 0
%D 2024 Jul 2
%M 38953730
%F 4.09
%R 10.1002/ppul.27156
%X <B>BACKGROUND: </B>An inadequate clearance of lung fluid plays a key role in the pathogenesis of transient tachypnea of the newborn (TTN).<BR><B>OBJECTIVE: </B>To evaluate if left ventricular diastolic dysfunction contributes to reduced clearance of lung fluid in TTN.<BR><B>METHODS: </B>This was a prospective, observational study. Echocardiography and lung ultrasound were performed at 2, 24 and 48 h of life (HoL) to assess biventricular function and calculate lung ultrasound score (LUS). Left atrial strain reservoir (LASr) provided surrogate measurement of left ventricular diastolic function.<BR><B>RESULTS: </B>Twenty-seven neonates with TTN were compared with 27 controls with no difference in gestation (36.1 ± 2 vs. 36.9 ± 2 weeks) or birthweight (2508 ± 667 vs. 2718 ± 590 g). Biventricular systolic function was normal in both groups. LASr was significantly lower in cases at 2 (21.0 ± 2.7 vs. 38.1 ± 4.4; p < 0.01), 24 (25.2 ± 4.5 vs. 40.6 ± 4.0; p < 0.01) and 48 HoL (36.5 ± 5.8 and 41.6 ± 5.2; p < 0.01), resulting in a significant group by time interaction (p < 0.001), after adjusting for LUS and gestational diabetes. A logistic regression model including LUS, birth weight and gestational diabetes as covariates, showed that LASr at 2 HoL was a predictor of respiratory support at 24 HoL, with an adjusted odds ratio of 0.60 (CI 0.36-0.99).<BR><B>CONCLUSIONS: </B>LASr was reduced in neonates with TTN, suggesting diastolic dysfunction, that may contribute to the delay in lung fluid clearance.