Reliability of Diastolic Flow Velocity of the Left Pulmonary Artery for the Diagnosis of Patent Ductus Arteriosus in Preterm Infants.

Baik,  Ji Hyun; Yoon,  Young Shin; Kim,  Gui Sook; Choi,  Byung Min; Lee,  Kee Hyoung; Eun,  Baik Lin; Yoo,  Kee Hwan; Hong,  Young Sook; Choi,  Chang Hee; Lee,  Joo Won

Original Article

Journal of the Korean Society of Neonatology 2003;10(2):168-177.
Published online November 1, 2003.

Reliability of Diastolic Flow Velocity of the Left Pulmonary Artery for the Diagnosis of Patent Ductus Arteriosus in Preterm Infants.

Ji Hyun Baik, Young Shin Yoon, Gui Sook Kim, Byung Min Choi, Kee Hyoung Lee, Baik Lin Eun, Kee Hwan Yoo, Young Sook Hong, Chang Hee Choi, Joo Won Lee

¹Department of Pediatrics, Seoul Adventist Hospital, Seoul, Korea.
²Department of Pediatrics, College of Medicine, Korea University, Seoul, Korea. iw6733@hotmail.com

미숙아 동맥관 개존의 진단시 좌폐동맥 확장기 혈류속도의 유용성

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Abstract

PURPOSE
Diagnosis of a hemodynamically significant patent ductus arteriosus (PDA) that should be treated is difficult to determine by clinical and echocardiographic examination. The purpose of this study is to clarify the usefulness of diastolic flow velocity (DFV) of the left pulmonary artery (LPA) determined by echocardiography in the assessment of significant PDA in preterm infants. METHODS: Clinical and echocardiographic findings, including DFV in LPA, of PDA were evaluated at 24 hours, 48-72 hours of age and after indomethacin treatment in thirty-nine infants ranging from 25 to 34 gestational weeks of age. DFVs of the study group (N=13) with significant PDA were compared with those of healthy control group (N=26) without significant PDA.
RESULTS
DFVs in healthy preterm infants were high in the first few days and were significantly decreased after spontaneous ductal closure. DFVs in preterm infants with significant PDA who underwent indomethacin treatment were significantly higher than that of healthy control infants. After indomethacin treatment, DFVs in this study group remained high with continuing significant PDA and markedly decreased with disappearance of significant PDA. Until ductus arteriosus closed, DFVs showed a significant correlation with the magnitudes of ductal shunt. A cutoff value for DFV of 30 cm/sec showed a sensitivity of 77% and a specificity of 92% as a predictor of significnat PDA in preterm infants. CONCLUSION: Measurement of DFV in LPA by echocardiography is a useful method for assessing the significnat PDA which may require treatment in preterm infants.

Key Words: Diastolic flow velocity; Left pulmonary artery; Echocardiography; Significant patent ductus arteriosus; Preterm infant