V. Schmer, C. Mogos, M. Gudavalli, V. G Sutija, A. Tugertimur
Ventricular dominance patterns in preterm infants
Objective: The purpose of the study was to determine
EKG and 2-D echocardiographic criteria of ventricular
dominance in preterm infants and select those by which
ventricular dominance could be established by EKG
alone.
Methods: A database was constructed from EKG and 2-D echocardiographic measurements on preterm infants
ranging in gestational ages from 23 to 34 weeks and
birth weights from 555–2490g, and fullterm controls.
Twelve-lead EKGs were obtained in the first 4 days of
life in 12 preterm infants and in the first 24 hours of
4 controls. 2-D echocardiograms were performed with
sweeps from the subcostal, parasternal, apical and suprasternal
views and M-mode measurements in the
short axis parasternal view on 11 of the preterm infants
and 9 fullterm controls.
Results: A definite leftward QRS axis for the preterm
infants (+19°, preterm; +133.75°, term; t = ?5.63;
p < 0.001) indicated a left ventricular (LV) dominance.
But R/S in favor of LV dominance for preterm infants
was apparent in V6 only. A pooled amplitude index for
each ventricle based on R and S wave from V1, V2, V5,
and V6 leads, showed LV dominance for the preterm
infants with a trend toward RV dominance with increasing
gestational age (F = 20.82; p < 0.001). RVD/LVED
M-mode echo ratios confirmed the LV dominance in
preterm infants.
Conclusion: A healthy full term infant is born with RV
dominance. LV dominance with a trend toward RV dominance
with increasing gestational age was found in
preterm infants by EKG and echo criteria.
Journal of Perinatal Medicine, Walter de Gruyter
Print ISSN: 1619-3997
Volume: 27, 09/1999
Pages: 287 - 291
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