Giulia Vanina Cantone, Abhijit Bhattacharya, David Healy, Dana Levinkopf, Anna Claudia Massolo, Flaminia Pugnaloni, Giovanni Vento, Anne Marie Heuchan, Florian Kipfmueller, Neil Patel
Fondazione Policlinico Universitario “A. Gemelli” IRCCS and Università Cattolica del Sacro Cuore. Royal Hospital for Children. “Bambino Gesù” Children Hospital – IRCCS. University Medical Center Mannheim and University Heidelberg.
Italy, United Kingdom and Germany
Pediatric Research
Pediatr Res 2025;
DOI: 10.1038/s41390-025-04560-6
Abstract
Background: Congenital diaphragmatic hernia (CDH) remains a major cause of neonatal mortality and morbidity. Early systolic left ventricular (LV) dysfunction is well described in CDH, while diastolic impairment remains unexplored. This study aimed to investigate the feasibility LV diastolic function assessment and to evaluate its relationship with clinical severity.
Methods: Observational, single-centre cohort study. In newborns with CDH, gestational age >32 weeks, echocardiographic assessment of diastolic function evaluation was performed at < 24 hours of age. Data were compared to normative values and correlated to clinical status and outcomes.
Results: Fifty-two infants were included, gestational age 38.0 (32.1-40.3) weeks. Diastolic function in CDH vs. normative controls were: LV mitral E wave 47 ( ± 14) vs. 56 ( ± 8) cm/sec, p < 0.001; LV tissue Doppler early diastolic velocity (e’) 4.1 ( ± 1.3) vs. 6.7 ( ± 1.4) cm/sec, p < 0.001; left atrial reservoir strain (LASr) 21.3 ( ± 8.7) vs 33.3 ( ± 4.4)%, p < 0.001; and E:e’ ratio 12 ( ± 4.2) vs. 33.3 ( ± 4.4), p < 0.001. LASr correlated with pCO2 (r2 = 0.22, p < 0.001) and FiO2 (r2 = 0.20, p < 0.001); was lower in non-survivors (p = 0.027) and infants requiring invasive ventilation at 14 days (p = 0.016).
Conclusions: Diastolic impairment is frequent in the first 24 hours of life in CDH and may contribute to disease severity.
Category
Heart Dysfunction Associated with Pulmonary Vascular Disease (Left)
Class III. Pulmonary Hypertension Associated with Lung Hypoplasia
Diagnostic Testing for Pulmonary Vascular Disease. Non-invasive Testing
Age Focus: Pediatric Pulmonary Vascular Disease
Fresh or Filed Publication: Fresh (PHresh). Less than 1-2 years since publication
Article Access
Free PDF File or Full Text Article Available Through PubMed or DOI: Yes