Outcomes of Left Ventricular Function According to Treatment Response for a Patent Ductus Arteriosus in Preterm Infants

Background: To evaluate the outcomes of left ventricular (LV) function according to treatment response for a hemodynamically significant patent ductus arteriosus (hsPDA) in preterm infants. Methods: Echocardiograms of 21 preterm infants born at gestational age < 31 weeks obtained at term-equivalent age were retrospectively studied. Among preterm infants with a hsPDA, 9 underwent ligation after failure of pharmacological closure (ligation group) and 6 experienced successful pharmacological closure (medication group). Six preterm infants without hsPDA (nohsPDA group) were studied as controls. LV peak longitudinal systolic strain (ε) of each infant was retrospectively obtained fromechocardiograms using velocity vector imaging, along with neonatal outcomes. Results: Pharmacological closures were attempted at postnatal day 2–3. In the ligation group, the median postnatal age at ligation was 20 days. In the ligation group, LV peak longitudinal systolic ε was significantly decreased at term-equivalent age compared to the other groups. Between the medication and no-hsPDA groups, LV peak longitudinal systolic ε did not differ significantly. Among the neonatal outcomes, infants who experienced necrotizing enterocolitis (NEC) showed significantly decreasedLV peak longitudinal systolic ε compared to the infants who did not experience NEC . Conclusion: We speculate that in preterm infants with an hsPDA, in cases of medical treatment failure, early PDA ligation atless than 20 days of postnatal age would be beneficial for preserving LV systolic function.