Children’s heart and prematurity: a current view of the problem

Abstract

Improved survival of children born with low, extremely low and very low body weight in modern conditions due to increased nursing capabilities, optimization of treatment and increased efficiency of resuscitation measures has led to the need for greater understanding of the importance of assessing the cardiovascular system’s state beyond the neonatal period. With approximately 10% of infants worldwide being born preterm, there is an increasing need for further research into optimal regimens, lifestyle and clinical interventions that can benefit and modify cardiovascular morphology and function in this growing population. Modern theoretical postulates on the physiology and pathophysiology of the child’s heart include ideas about the key process of cardiac biomechanics — diastole, during which the earliest disturbances, that precede the formation of systolic dysfunction, occur. Assessment of the pumping properties of the left ventricle in systole and diastole is a fundamental methodological technique for an in-depth understanding of the pathophysiological mechanisms of cardiovascular system’s emerging diseases, their early diagnosis and assessment of the complex therapy’s effectiveness. However, despite the widespread use of standard echocardiography to assess systolic and diastolic function, its traditional parameters have limitations in terms of diagnostic accuracy and effectiveness in practice. Expanding knowledge about new pathogenetic mechanisms of the cardiac dysfunction formation in conditions of prematurity at the current stage of cardiology development using the “trace spot” technology (two-dimensional speckle tracking echocardiography) will be very useful for scientists studying the mechanics formation of the child’s heart after premature birth, and for doctors of various specialties in early diagnosis of heart diseases.

Keywords

prematurity / child's heart / left ventricular mechanics / diastolic dysfunction

Funding

Исследование выполнено в соответствии с планом НИИ кардиологии Томского НИМЦ по фундаментальной теме «Фундаментальные аспекты формирования структурно-функциональных изменений сердца и сосудов в разных возрастных группах на доклинической, клинической стадиях и после гемодинамической коррекции сердечно-сосудистых заболеваний».The study was carried out in accordance with the plan of the Research Institute of Cardiology of the Tomsk National Research Medical Center on the fundamental topic “Fundamental aspects of the structural and functional changes formation in the heart and blood vessels in different age groups at the preclinical, clinical stages and after hemodynamic correction of cardiovascular diseases”.

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