ABNORMAL LEFT-VENTRICULAR DIASTOLIC FILLING PATTERNS IN SMALL-FOR-GESTATIONAL-AGE INFANTS

Doppler transmitral flow velocity patterns in assessing left ventricul ar diastolic function in small-for-gestational-age infants have been p oorly understood. The purpose of this study is to examine Doppler fill ing patterns in small-for-gestational-age infants (n = 13) and to comp are them with those in age-matched appropriate-for-gestational-age inf ants (n = 29). We measured peak flow velocities of early diastole (pea k E wave) and atrial contraction (peak A wave), ratio of peak E wave t o peak A wave (peak E/A wave), velocity time integrals of E wave (VTIE wave) and A wave (VTIA wave), ratio of VTIE wave to VTIA wave (VTIE/A wave), first third filling fraction, peak filling rate normalized to stroke volume, and deceleration time. Mean gestational age and heart r ate did not show a significant difference between the appropriate- and the small-for-gestational-age infants. The mean birth weight in the s mall-for-gestational-age infants was significantly lower than that in the appropriate-for-gestational-age infants (802+/-220 vs. 1184+/-260 g, P<0.01). In the small-for-gestational-age infants, the peak E wave, peak A wave, peak E/A wave,VTIE wave, first third filling fraction, a nd peak filling rate normalized to stroke volume were significantly lo wer than those in the age-matched appropriate-for-gestational-age infa nts (21.9+/-6.7 vs. 32.2+/-6.9 cm/s, 26.5+/-6.2 vs. 34.5+/-6.2 cm/s, 0 .82+/-0.15 vs. 0.93+/-0.14, 1.88+/-0.45 vs. 2.39+/-0.51 cm, 0.36+/-0.0 4 vs. 0.41+/-0.04, 5.86+/-0.75 vs. 7.11+/-0.63/s, P<0.05, respectively ). In the small and appropriate for gestational age infants, peak E wa ve, VTIE wave, and peak E/A increased significantly with increasing bo dy weight. In the small-for-gestational-age infants, the slopes of reg ression lines between body weights and peak E wave and VTIE wave were significantly lower than those in the appropriate for gestational age infants, suggesting a significant reduction in E wave even when consid ering a difference in their body weight. This study suggests that the significant decreases in the early diastolic filling in the small-for- gestational-age infants may be related to reduced left ventricular dia stolic function. reserved. (C) 1998 Elsevier Science Ireland Ltd. All rights reserved.