Patent ductus arteriosus (PDA) affects preterm infants and alters heart function. High-risk cases need close watch on treatment response. A study published in the Cardiology in the Young tracks echocardiographic changes over time in three groups. It compares high-risk infants with successful treatment, those with failed treatment, and low-risk ones needing no drugs. Findings guide when to push for duct closure.
Cohort and Echo Timeline
Researchers followed preterm infants born before 29 weeks gestation. They used EL-Khuffash PDA Severity Score to split into high-risk and low-risk. High-risk got medical therapy and split by response. Echoes happened at day 2, 2 weeks, and 36 weeks corrected age. They measured wall thickness, strain, velocities, and perfusion across groups of 184 total infants.
Group Differences Emerge Early
Of 184 infants, 58 were high-risk with treatment success, 52 high-risk with failure, and 74 low-risk. Treatment failure group kept thicker left ventricular walls and lower coeliac velocities at follow-up. Success group gained better strain, perfusion, and structure. Low-risk infants closed PDA on their own with steady haemodynamics. Group trajectories diverged sharply from day 2 to week 2 echoes.
Guide Interventions with Serial Scans
Failed PDA treatment sustains heart and flow issues in high-risk preterms. Success brings back normal adaptation. Low-risk fare well naturally. Routine echoes spot at-risk infants early. Aim for quick closure to avoid remodelling damage.