For a study, researchers sought to investigate relationships between surveillance testing and clinical outcomes in newborns with single right ventricle (sRV) physiology. Participants with sRV who had initial palliative surgery were considered for inclusion in this prospective study conducted at a single center (September 2019 to December 2020). As a component of clinical therapy, echocardiograms and B-type naturetic peptides (BNP) obtained during the previous 24 hours were included in the study. The immediate repercussion was either passing away or requiring a heart transplant. Secondary outcomes were the length of milrinone used between phases, the length of time patients stayed in the hospital, and the absence of digoxin use. sRV functional evaluation was performed offline (subjective grade, fractional area change, tricuspid annular plane systolic excursion, global longitudinal strain, right atrial strain [RAS]). They determined the relationships between echocardiography, BNP, and clinical outcomes. Around 20 out of 26 individuals (47 encounters) had hypoplastic left heart syndrome (77%). About 50 days was the median age at data collection (interquartile range 26 to 90). In most cases (73%), subjective sRV function was normal. The median BNP concentration was 332 pg/ml (interquartile range 160 to 1,085). In 5 patients (19%) reached the primary endpoint and had a reduced RAS (14.1 vs. 21.3, P=0.038), but all other characteristics were comparable to transplant-free survivors. RAS had the greatest area under the curve (16.1%, 0.83), followed by global longitudinal strain (−14.4%, 0.77). Higher RAS was linked with fewer days on milrinone (coefficient 1.37, 95% CI −2.54 to −0.20, P=0.02) and a greater likelihood of digoxin use (odds ratio 1.09, 95% CI 1.01 to 1.20, P=0.047). Higher BNP was only related to a decreased likelihood of digoxin use (odds ratio 0.69, 95% CI: 0.5 to 0.96, P=0.03). Because of this finding, RAS was a potentially important imaging signal in infants with sRV; it needed further examination in bigger trials.
Source – ajconline.org/article/S0002-9149(22)00533-1/fulltext
