Establishment of reference ranges for left ventricular functional parameters in neonatal echocardiography:a multicenter,prospective,observational study

YANG Jing-li; AN Yan-bin; WANG Jian-ping; HUANG Lie; DENG Bo-yin; FAN Ying; DONG Wen-hui; WANG Jian-hui; SHI Yuan

doi:10.19538/j.ek2025080614

Abstract：Objective To establish reference ranges for left ventricular functional parameters in neonatal echocardiography across different postnatal time intervals,stratified by gestational age(GA),birth weight,and gender,thereby providing reference for left ventricular functional assessment in the application of neonatal critical care bedside cardiac ultrasound.Methods This multicenter,prospective,observational study enrolled 406 term neonates hospitalized or receiving outpatient care at the Children's Hospital of Chongqing Medical University,Yinchuan First People's Hospital of Ningxia Autonomous Region,and Inner Mongolia Maternal and Child Health Hospital between June 2023 and May 2024.Bedside echocardiography was performed by trained neonatologists or sonographers to measure parameters reflecting left ventricular systolic and diastolic function.Reference ranges(95％confidence intervals)were established for postnatal days 1,3,7,14,and 28,with stratification by GA and birth weight.Results Among the 406 term neonates(204 males,202 females),mean GA was(38.9±1.5)weeks,and mean birth weight was(3197.8±449.5)g.Multiple left ventricular functional parameters-including left ventricular outflow tract stroke volume(LVO),weight-indexed LVO(LVO*),mitral annular plane systolic excursion(MAPSE),mitral valve early(MV-E)and late(MV-A)diastolic inflow velocities,and pulmonary vein S/D ratio-showed significant associations with birth weight and GA(all P＜0.05).LVO,LVO*,MV-E,MV-A,MV-E/e'ratio(early diastolic inflow velocity to lateral mitral annular tissue Doppler e'velocity),pulmonary vein S-wave velocity,and pulmonary vein S/D ratio were correlated with postnatal age(all P＜0.05).No parameters exhibited gender-related differences(all P＞0.05).Conclusion Neonatal left ventricular systolic and diastolic functional parameters are associated with postnatal age,GA,and birth weight.This study establishes comprehensive reference ranges for left ventricular functional assessment,stratified by age,GA and birth weight,which play a crucial role in guiding refined hemodynamic evaluation and management of critically ill neonates.