90 Systemic doppler velocities in newborns with congenital heart defects - A prospective study
Bibliographic record
Abstract
Abstract Background Neonates with congenital heart disease (CHD) are at high risk for systemic steal, hypoperfusion, and organ dysfunction due to abnormal cardiac anatomy and persistent shunts. Understanding these physiological changes is crucial for optimizing management strategies and improving outcomes. Objectives To evaluate longitudinal ultrasonographic (US) estimators of systemic blood flow during the postnatal transition in neonates with CHD using Doppler measurements of the aorta (Ao) during the first week of life. Design/Methods This prospective observational single-center study recruited neonates born at ≥34 weeks' gestation between 2018 and 2021 with CHD requiring NICU admission. Infants with significant genetic anomalies were excluded. Daily Aortic (Ao) ultrasounds were performed until day 7 of life, discharge, or cardiac intervention. Pulse-wave Doppler measurements were obtained from the suprasternal (ascending, preductal and postductal descending Ao) and subcostal views (postductal Ao). Key measurements included velocity-time integral (VTI), peak systolic velocity (PSV), end-diastolic velocity (EDV), and mean velocity (VM). Temporal changes and associations with retrograde flow were analyzed using mixed-effects models to assess systemic blood flow dynamics during the postnatal transition. Results Of the 62 enrolled neonates, data from 22 were analyzed (work in progress). CHD types in this cohort are detailed in Table 1. Over the first week, heart rate significantly increased (Table 2). VTI at the ascending aorta increased over time (β = 0.004, p = 0.03), and VM increased at both the ascending (β = 0.02, p = 0.009) and preductal sites (β = 0.02, p = 0.009), suggesting compensatory mechanisms to maintain cerebral perfusion (while PVR is dropping). Retrograde flow was linked to significant HR increases (Table 2) and VM decreases at the subcostal (β = –0.12, p = 0.02) and postductal sites (β = –0.2, p < 0.001). EDV at the subcostal site became more negative with retrograde flow (β = –0.19, p = 0.005). Conclusion Preliminary data suggest neonates with CHD undergo significant hemodynamic changes during the early postnatal period, including increased HR and differencial flow velocity time evolution in pre and post ductal Aorta, reflecting compensatory mechanisms for maintaining cerebral and systemic perfusion. These findings emphasize the value of hemodynamic monitoring to provide real-time insights not always evident through standard assessments, aiding in optimizing clinical management.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".