Phonocardiography and patent ductus arteriosus in preterm infants
Keywords:
patent ductus arteriosus, hemodynamically significant patent ductus arteriosus, phonocardiogram, preterm infantsAbstract
Purpose. To investigate the possibility of heart tones analysis for diagnostic screening of ductus arteriosus status in preterm infants based on the analysis of computer phonocardiogram parameters for different hemodynamic significance of patent ductus arteriosus.
Materials and methods. 45 preterm infants undergoing treatment in the intensive care unit were examined. phonocardiogram (PCG) with an electronic stethoscope and echocardiography were performed. 40 (89%) newborns had ultrasound signs of hemodynamically insignificant patent ductus arteriosus (PDA) (PDA with minor shunting), 5 infants (11%) had signs of hemodynamically significant patent ductus arteriosus (HSPDA). A comparison of the 5 key PCG computer analysis indicators (characteristics of the tones and the interval between the first and second tones) was performed.
Results. Significant differences of particular indicators of PCG computer analysis of preterm infants with different shunting intensity of PDA were established. These indicators characterize the intervals between the first and the second tones in case if comparing minor and moderate shunting, and additional indicators characterize the ratio between the first and the second tones if comparing moderate and significant shunting. The indicators can be used to develop a screening diagnostics algorithm for the hemodynamic significance of PDA by means of PCG computer analysis.
Conclusions. Statistically significant differences in PCG analysis were found in preterm infants with varying degrees of hemodynamic significance of the patent ductus arteriosus. The results obtained can be used as a diagnostic screening in preterm infants with PDA.
The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of an participating institution. The informed consent of the patient was obtained for conducting the studies.
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