Elsevier

The Journal of Pediatrics

Volume 125, Issue 3, September 1994, Pages 447-451
The Journal of Pediatrics

Evaluation of left ventricular mass in children with left-sided congenital diaphragmatic hernia

https://doi.org/10.1016/S0022-3476(05)83293-7Get rights and content

To evaluate left ventricular (LV) mass in children with left-sided congenital diaphragmatic hernia (CDH), we retrospectively examined the echocardiographic data availlable on all newborn infants with a diagnosis of CDH between April 1989 and May 1993. Adequate data for evaluation were available for 20 of 31 patients with left-sided CDH and no significant congenital heart disease. Left ventricular mass was determined from two-dimensional echocardiograms by an area-length method. Findings were compared with a control group that consisted of neonates with other causes of pulmonary hypertension. Patients with left-sided CDH had a significantly lower indexed LV mass than control subjects (1.96 gm/kg±0.59 vs 2.84 gm/kg±0.41; p=0.0001). Additionally, children with left-sided CDH who required extracorporeal membrane oxygenation before repair (n=7) had a significantly lower indexed LV mass than those patients who did not require extracorporeal membrane oxygenation before repair (1.53 gm/kg±0.50 vs 2.20 gm/kg±0.52; (p=0.007). Infants who survived (n=13) had an indexed LV mass of 2.09 gm/kg±0.58 vs 1.64 gm/kg±0.58 in those who died (p=0.07). We conclude that the LV mass index in children with left-sided CDH is significantly lower than in children with other causes of pulmonary hypertension in the newborn period. Evaluation of LV mass in neonates with left-sided CDH may help predict the need for extracorporeal support before surgical repair, and may help indicate overall prognosis.

Cited by (105)

  • Pulmonary Hypertension of the Newborn

    2023, Principles of Neonatology
  • Implications of Atrial-Level Shunting by Echocardiography in Newborns with Congenital Diaphragmatic Hernia

    2020, Journal of Pediatrics
    Citation Excerpt :

    This is likely explained by the marked difference in severity of CDH for the right-to-left shunting group, with a lower percentage of predicted lung volume and greater percentage of liver herniation in this subset. This finding is consistent with previous reports of lower LV volume in the most severe subset of newborns with CDH.8 Moreover, the direction of atrial-level shunting was unrelated to the severity of LV dysfunction in this cohort.

View all citing articles on Scopus
View full text