Assessing Intracardiac Vortices with High Frame-Rate Echocardiography-Derived Blood Speckle Imaging in Newborns

We’re try to explore why preterm babies when they’re born preterm and grow into adults have a significant higher risk of heart failure. We think it has to do with an abnormal cardiac development because they were born 10 or sometimes 15 weeks early and where pressure in the heart has changed. We can now capture this kind of changes with looking at intracardiac blood flow patterns with blood speckle imaging.

Hopefully we’ll be able to select babies very early on in this crucial period of cardiac development and maybe apply some preventive strategies with a future goal to also prevent heart failure when they grow up to be adults. Well, from a practical point of view, the challenges always fall back on image quality and the acquisition of clear cardiac structures in an echo. And what’s more, it’s additionally challenging because we’re dealing with babies and we sometimes have very unsettled patients.

So we did two studies with blood speckle imaging, one to look if the technique was actually feasible in this population and the answer was yes, it’s very feasible. It’s very nice images of intracardiac blood flow patterns in these preterm population. And the second we followed the cohort of 80 preterm infant, and we measured them at day five to seven and then again at discharge.

And then we categorized them in the babies who had this cardiac remodeling of prematurity and the ones who did not. And we found out that the babies who had cardiac modeling also had abnormal vortex formations at day seven. The vortexes were way more larger and rounder than in the babies who did not develop cardiac remodeling.

This might be a very important clue moving forward in exploring which babies might be amenable to preventive treatments. Well, currently there’s limited research available on the use of echo derived blood speckle imaging and neonates. So what we’ve currently been doing is looking at cardiac development after preterm birth.

But what remains to be explored is the association between diastolic dysfunction and intracardiac blood flow, like vortices and vortex exclamation. Echo derived blood speckle imaging is a completely non-invasive tool compared to other technologies like MRI. It’s also fairly cheap to use and it’s very useful as a bedside tool, meaning it can be brought into the rooms next to patients and minimizing inconvenience to the patients.