Background and Aims Therapeutic hypothermia after perinatal asphyxia reduces brain damage. The impact on the heart is poorly investigated. This study compare myocardial performance (MP) by ultrasound (Strain and Strain-Rate by tissue Doppler) in cooled asphyxiated term neonates (HT), asphyxiated term neonates treated with normothermia (NT) and non-asphyxiated term neonates (CTR).
Methods MP were compared in 44 HT during and after cooling, 20 NT and 48 CTR.
Results The HT-group was more severely asphyxiated than the NT-group (pH 7.07 (7.02, 7.12) (mean (95%CI)) vs. 7.21 (7.14, 7.30), Base-Excess –16.11mmol/L (–17.8, –14.3) vs. –9.3 (–13.0, –5.6) (p<0.05)).
On day 1–3, the MP was similar in the NT-group and HT-group during cooling, lower than in the CTR-group (p<0.05). The MP within each group was similar, except the CTR-group and HT-group Peak Systolic Strain and HT-group Strain-Rate during the Atrial Systole (p<0.05).
After rewarming, the MP improved in the HT-group (day 4), approaching the MP in the CTR-group on day 3.
Conclusions Although the HT-group was more severely asphyxiated than the NT-group, the myocardial performance was similarly depressed on day 1–3. The myocardial performance in the HT-group improved after rewarming (day 4), approaching the level in the CTR-group on day 3. Therapeutic hypothermia did not decrease the myocardial performance during treatment and might have had a positive impact after treatment.
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