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The effect of antenatal magnesium sulfate on left ventricular afterload and myocardial function measured using deformation and rotational mechanics imaging

Journal of Perinatology volume 35, pages 913–918 (2015)Cite this article

Subjects

Abstract

Objective:

Assess the effect of antenatal magnesium sulfate (MgSO4) on left ventricular function measured using deformation and rotational mechanics imaging.

Study Design:

Infants who received MgSO4 were matched for gestation, birth weight and mode of delivery with controls. Echocardiography was carried out on days 1 and 2 to measure left ventricle longitudinal strain (LV LS), twist, untwist rate, ejection fraction (EF), and systemic vascular resistance (SVR).

Results:

Thirty-eight infants with a median gestation and birth weight of 27.1 weeks and 923 g were included. On day 1, the MgSO4 group (n=19) had a lower SVR and higher LV LS, EF, twist and untwist rate than the Control group (n=19) (all P<0.05). There were no differences between the groups on day 2.

Conclusion:

Antenatal MgSO4 administration is associated with a lower SVR and higher myocardial function on day 1 in preterm infants <29 weeks gestation.

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References

  1. Doyle LW, Crowther CA, Middleton P, Marret S, Rouse D . Magnesium sulphate for women at risk of preterm birth for neuroprotection of the fetus. Cochrane Database Syst Rev 2009; (1): CD004661.

  2. Doll E, Wilkes J, Cook LJ, Korgenski EK, Faix RG, Yoder BA et al. Neonatal magnesium levels correlate with motor outcomes in premature infants: a long-term retrospective cohort study. Front Pediatr 2014; 2: 120.

    Article  Google Scholar 

  3. Imamoglu EY, Gursoy T, Karatekin G, Ovali F . Effects of antenatal magnesium sulfate treatment on cerebral blood flow velocities in preterm neonates. J Perinatol 2014; 34 (3): 192–196.

    Article  CAS  Google Scholar 

  4. Shokry M, Elsedfy GO, Bassiouny MM, Anmin M, Abozid H . Effects of antenatal magnesium sulfate therapy on cerebral and systemic hemodynamics in preterm newborns. Acta Obstet Gynecol Scand 2010; 89 (6): 801–806.

    Article  CAS  Google Scholar 

  5. Paradisis M, Osborn DA, Evans N, Kluckow M . Randomized controlled trial of magnesium sulfate in women at risk of preterm delivery-neonatal cardiovascular effects. J Perinatol 2012; 32 (9): 665–670.

    Article  CAS  Google Scholar 

  6. James A, Corcoran JD, Mertens L, Franklin O, El-Khuffash A . Left ventricular rotational mechanics in preterm infants less than 29 weeks' gestation over the first week after birth. J Am Soc Echocardiogr 2015; 28 (7): 808–817.

    Article  Google Scholar 

  7. El-Khuffash AF, Jain A, Dragulescu A, McNamara PJ, Mertens L . Acute changes in myocardial systolic function in preterm infants undergoing patent ductus arteriosus ligation: a tissue Doppler and myocardial deformation study. J Am Soc Echocardiogr 2012; 25 (10): 1058–1067.

    Article  Google Scholar 

  8. El-Khuffash AF, Jain A, Weisz D, Mertens L, McNamara PJ . Assessment and treatment of post patent ductus arteriosus ligation syndrome. J Pediatr 2014; 165 (1): 46–52.

    Article  CAS  Google Scholar 

  9. Sehgal A, Wong F, Menahem S . Speckle tracking derived strain in infants with severe perinatal asphyxia: a comparative case control study. Cardiovasc Ultrasound 2013; 11: 34.

    Article  Google Scholar 

  10. James AT, Corcoran JD, Jain A, McNamara PJ, Mertens L, Franklin O et al. Assessment of myocardial performance in preterm infants less than 29 weeks gestation during the transitional period. Early Hum Dev 2014; 90 (12): 829–835.

    Article  Google Scholar 

  11. Papile LA, Burstein J, Burstein R, Koffler H . Incidence and evolution of subependymal and intraventricular hemorrhage: a study of infants with birth weights less than 1,500 gm. J Pediatr 1978; 92 (4): 529–534.

    Article  CAS  Google Scholar 

  12. Mertens L, Seri I, Marek J, Arlettaz R, Barker P, McNamara P et al. Targeted neonatal echocardiography in the neonatal intensive care unit: practice guidelines and recommendations for training writing group of the American Society of Echocardiography (ASE) in collaboration with the European Association of Echocardiography (EAE) and the Association for European Pediatric Cardiologists (AEPC). J Am Soc Echocardiogr 2011; 24 (10): 1057–1078.

    Article  Google Scholar 

  13. de Waal K, Lakkundi A, Othman F . Speckle tracking echocardiography in very preterm infants: feasibility and reference values. Early Hum Dev 2014; 90 (6): 275–279.

    Article  Google Scholar 

  14. Lopez L, Colan SD, Frommelt PC, Ensing GJ, Kendall K, Younoszai AK et al. Recommendations for quantification methods during the performance of a pediatric echocardiogram: a report from the Pediatric Measurements Writing Group of the American Society of Echocardiography Pediatric and Congenital Heart Disease Council. J Am Soc Echocardiogr 2010; 23 (5): 465–495.

    Article  Google Scholar 

  15. Rowland DG, Gutgesell HP . Use of mean arterial pressure for noninvasive determination of left ventricular end-systolic wall stress in infants and children. Am J Cardiol 1994; 74 (1): 98–99.

    Article  CAS  Google Scholar 

  16. Noori S, Friedlich P, Seri I, Wong P . Changes in myocardial function and hemodynamics after ligation of the ductus arteriosus in preterm infants. J Pediatr 2007; 150 (6): 597–602.

    Article  Google Scholar 

  17. Levy PT, Holland MR, Sekarski TJ, Hamvas A, Singh GK . Feasibility and reproducibility of systolic right ventricular strain measurement by speckle-tracking echocardiography in premature infants. J Am Soc Echocardiogr 2013; 26 (10): 1201–1213.

    Article  Google Scholar 

  18. Levy PT, Dioneda B, Holland MR, Sekarski TJ, Lee CK, Mathur A et al. Right ventricular function in preterm and term neonates: reference values for right ventricle areas and fractional area of change. J Am Soc Echocardiogr 2015; 28: 559–569.

    Article  Google Scholar 

  19. Anavekar NS, Gerson D, Skali H, Kwong RY, Yucel EK, Solomon SD . Two-dimensional assessment of right ventricular function: an echocardiographic-MRI correlative study. Echocardiography 2007; 24 (5): 452–456.

    Article  Google Scholar 

  20. Kowalik E, Kowalski M, Hoffman P . Is right ventricular myocardial deformation affected by degree of interatrial shunt in adults? Eur J Echocardiogr 2011; 12 (5): 400–405.

    Article  Google Scholar 

  21. Fawcett WJ, Haxby EJ, Male DA . Magnesium: physiology and pharmacology. Br J Anaesth 1999; 83 (2): 302–320.

    Article  CAS  Google Scholar 

  22. Scardo JA, Hogg BB, Newman RB . Favorable hemodynamic effects of magnesium sulfate in preeclampsia. Am J Obstet Gynecol 1995; 173 (4): 1249–1253.

    Article  CAS  Google Scholar 

  23. Dyckner T . Serum magnesium in acute myocardial infarction. Relation to arrhythmias. Acta Med Scand 1980; 207 (1–2): 59–66.

    CAS  PubMed  Google Scholar 

  24. Ferferieva V, Van den Bergh A, Claus P, Jasaityte R, Veulemans P, Pellens M et al. The relative value of strain and strain rate for defining intrinsic myocardial function. Am J Physiol Heart Circ Physiol 2012; 302 (1): H188–H195.

    Article  CAS  Google Scholar 

  25. Rantonen T, Kaapa P, Gronlund J, Ekblad U, Helenius H, Kero P et al. Maternal magnesium sulfate treatment is associated with reduced brain-blood flow perfusion in preterm infants. Crit Care Med 2001; 29 (7): 1460–1465.

    Article  CAS  Google Scholar 

  26. Buckberg G, Hoffman JI, Nanda NC, Coghlan C, Saleh S, Athanasuleas C . Ventricular torsion and untwisting: further insights into mechanics and timing interdependence: a viewpoint. Echocardiography 2011; 28 (7): 782–804.

    Article  Google Scholar 

  27. Burns AT, La GA, Prior DL, Macisaac AI . Left ventricular torsion parameters are affected by acute changes in load. Echocardiography 2010; 27 (4): 407–414.

    Article  Google Scholar 

  28. Lee A, Liestol K, Nestaas E, Brunvand L, Lindemann R, Fugelseth D . Superior vena cava flow: feasibility and reliability of the off-line analyses. Arch Dis Child Fetal Neonatal Ed 2010; 95 (2): F121–F125.

    Article  CAS  Google Scholar 

  29. Ficial B, Finnemore AE, Cox DJ, Broadhouse KM, Price AN, Durighel G et al. Validation study of the accuracy of echocardiographic measurements of systemic blood flow volume in newborn infants. J Am Soc Echocardiogr 2013; 26 (12): 1365–1371.

    Article  Google Scholar 

  30. Noori S, McCoy M, Anderson MP, Ramji F, Seri I . Changes in cardiac function and cerebral blood flow in relation to peri/intraventricular hemorrhage in extremely preterm infants. J Pediatr 2014; 164 (2): 264–270.

    Article  Google Scholar 

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Acknowledgements

This research has received funding from the EU FP7/2007-2013 under grant agreement no. 260777 (the HIP Trial) and from Friends of the Rotunda Research Grant (reference: FoR/EQUIPMENT/101572).

Author information

Authors and Affiliations

  1. Department of Neonatology, The Rotunda Hospital, Dublin, Ireland

    A T James, J D Corcoran, B Hayes & A EL-Khuffash

  2. Department of Paediatrics, The Royal College of Surgeons in Ireland, Dublin, Ireland

    J D Corcoran & A EL-Khuffash

  3. Department of Paediatric Cardiology, Our Lady’s Children’s Hospital Crumlin, Dublin, Ireland

    O Franklin

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  1. A T James
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  2. J D Corcoran
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  3. B Hayes
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  4. O Franklin
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  5. A EL-Khuffash
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Corresponding author

Correspondence to A EL-Khuffash.

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James, A., Corcoran, J., Hayes, B. et al. The effect of antenatal magnesium sulfate on left ventricular afterload and myocardial function measured using deformation and rotational mechanics imaging. J Perinatol 35, 913–918 (2015). https://doi.org/10.1038/jp.2015.104

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