@Article{chd.12454,
AUTHOR = {Koert de Waal, Nilkant Phad, Nick Collins, Andrew Boyle},
TITLE = {Cardiac remodeling in preterm infants with prolonged exposure to a patent ductus arteriosus},
JOURNAL = {Structural and Congenital Heart Disease},
VOLUME = {12},
YEAR = {2017},
NUMBER = {3},
PAGES = {364--372},
URL = {http://www.techscience.com/schd/v12n3/39122},
ISSN = {3071-1738},
ABSTRACT = {<b>Background:</b> Sustained volume load due to a patent ductus arteriosus (PDA) leads to cardiac
remodeling. Remodeling changes can become pathological and are associated with cardiovascular
disease progression. Data on remodeling changes in preterm infants is not available.<br/>
<b>Methods:</b> Clinical and echocardiography data were collected in preterm infants <30 weeks gestation on postnatal day 3 and then every 7–14 days until closure of the ductus arteriosus. Images
were analyzed using conventional techniques and speckle tracking. Remodeling changes of infants
with prolonged (>14 days) exposure to a PDA were compared to control infants without a PDA.<br/>
<b>Results:</b> Thirty out of 189 infants had prolonged exposure to a PDA. The left heart remodeled to
a larger and more spherical shape and thus significantly increased in volume. Most changes
occurred in the first 4 weeks, plateaued, and then returned to control values. Systolic function and
estimates of filling pressure increased and effective arterial elastance reduced with a PDA, however contractility was unchanged. Wall thickness increased after 4 weeks of increased volume
exposure.<br/>
<b>Conclusion:</b> The preterm PDA induces early and significant remodeling of the left heart. A compensated cardiac physiology was seen with preserved systolic function, suggesting adaptive rather
than pathological remodeling changes with prolonged exposure to a PDA.},
DOI = {10.1111/chd.12454}
}