Children’s heart and prematurity: a current view of the problem

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Abstract

Improved survival of children born with low, extremely low and very low body weight in modern conditions due to increased nursing capabilities, optimization of treatment and increased efficiency of resuscitation measures has led to the need for greater understanding of the importance of assessing the cardiovascular system’s state beyond the neonatal period. With approximately 10% of infants worldwide being born preterm, there is an increasing need for further research into optimal regimens, lifestyle and clinical interventions that can benefit and modify cardiovascular morphology and function in this growing population. Modern theoretical postulates on the physiology and pathophysiology of the child’s heart include ideas about the key process of cardiac biomechanics — diastole, during which the earliest disturbances, that precede the formation of systolic dysfunction, occur. Assessment of the pumping properties of the left ventricle in systole and diastole is a fundamental methodological technique for an in-depth understanding of the pathophysiological mechanisms of cardiovascular system’s emerging diseases, their early diagnosis and assessment of the complex therapy’s effectiveness. However, despite the widespread use of standard echocardiography to assess systolic and diastolic function, its traditional parameters have limitations in terms of diagnostic accuracy and effectiveness in practice. Expanding knowledge about new pathogenetic mechanisms of the cardiac dysfunction formation in conditions of prematurity at the current stage of cardiology development using the “trace spot” technology (two-dimensional speckle tracking echocardiography) will be very useful for scientists studying the mechanics formation of the child’s heart after premature birth, and for doctors of various specialties in early diagnosis of heart diseases.

About the authors

Elena N. Pavlyukova

Research Institute of Cardiology, Tomsk National Research Medical Center of the Russian Academy of Sciences

Author for correspondence.
Email: pavluk@cardio-tomsk.ru
ORCID iD: 0000-0002-3081-9477
SPIN-code: 5794-3627
Scopus Author ID: 6507428859
ResearcherId: P-8477-2016

M.D., D. Sci. (Med.), Prof., Head of Depart., Depart. of Atherosclerosis and Chronic Coronary Heart Disease, Research Institute of Cardiology

Russian Federation, Tomsk

Marina V. Kolosova

Siberian State Medical University

Email: kolosova_mv@inbox.ru
ORCID iD: 0000-0002-5550-5925
SPIN-code: 1982-4987

M.D., D. Sci. (Med.), Prof.,Depart. of Children's Diseases

Russian Federation, Tomsk

Galina V. Neklyudova

Research Institute of Cardiology, Tomsk National Research Medical Center of the Russian Academy of Sciences

Email: lv-gal@mail.ru
ORCID iD: 0000-0002-7556-9379
SPIN-code: 9958-8105

PhD Stud., Research Institute of Cardiology

Russian Federation, Tomsk

Evgeniya O. Alexeeva

Research Institute of Cardiology, Tomsk National Research Medical Center of the Russian Academy of Sciences

Email: alexeeva_777@mail.ru
ORCID iD: 0000-0003-0335-9126

PhD Stud., Research Institute of Cardiology

Russian Federation, Tomsk

Rostislav S. Karpov

Research Institute of Cardiology, Tomsk National Research Medical Center of the Russian Academy of Sciences

Email: karpov@cardio-tomsk.ru
ORCID iD: 0000-0002-7011-4316
SPIN-code: 8263-2641

M.D., D. Sci. (Med.), Academician of the Russian Academy of Sciences, Scientific Supervisor, Research Institute of Cardiology

Russian Federation, Tomsk

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2. Fig. 1. Mechanisms of formation of diastole and diastolic vortex flows of the left ventricle (LV), their complex effects in infants and preschoolers born prematurely with low, very low and extremely low body weight, during postnatal growth and ongoing tissue differentiation of the heart (hypothesis). A. Mechanisms of formation and parameters characterizing LV diastole. B. Characteristics of intracardiac diastolic flows and types of LV twist into systole. C. Variants of LV untwist into diastole with various models of rotational movement in LV systole and complex effects of intracardiac hemodynamics. LA — left atrium; CMC — cardiomyocytes

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