Objective Our aim was to determine whether right ventricular (RV) dysfunction at 24-hour postnatal age predicts adverse developmental outcome among patients with hypoxic ischaemic encephalopathy (HIE) undergoing therapeutic hypothermia (TH). Design Neonates≥35 weeks with HIE/TH were enrolled in a physiological study in the neonatal period (n=46) and either died or underwent neurodevelopmental follow-up at 18 months (n=43). The primary outcome was a composite of death, diagnosis of cerebral palsy or any component of the Bayley Scores of Infant Development III<70. We hypothesised that tricuspid annulus plane systolic excursion (TAPSE) <6 mm and/or RV fractional area change (RV-FAC) <0.29 would predict adverse outcome. Results Nine patients died and 34 patients were followed up at a mean age of 18.9±1.4 months. Both indices of RV systolic performance were abnormal in 15 (35%) patients, TAPSE <6 mm only was abnormal in 4 (9%) patients and RV-FAC <0.29 only was abnormal in 5 (12%) patients (19 had with normal RV function). Although similar at admission, neonates with RV dysfunction had higher cardiovascular and neurological illness severity by 24 hours than those without and severe MRI abnormalities (70% vs 53%, p=0.01) were more common. On logistic regression, TAPSE <6 mm (OR 3.6, 95% CI 1.2 to 10.1; p=0.017) and abnormal brain MRI [OR 21.7, 95% CI 1.4 to 336; p=0.028) were independently associated with adverse outcome. TAPSE <6 mm predicted outcome with a 91% sensitivity and 81% specificity. Conclusions The role of postnatal cardiovascular function on neurological outcomes among patients with HIE who receive TH merits further study. Quantitative measurement of RV function at 24 hours may provide an additional neurological prognostic tool. Data are available on reasonable request. Data used to generate the conclusions in this work are available as supplementary materials. For discussion of further data, please contact the corresponding author.

中文翻译：

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缺氧缺血性脑病和治疗性低温后的神经发育结果与出生后 24 小时的右心室功能有关

目的 我们的目的是确定出生后 24 小时的右心室 (RV) 功能障碍是否预示着接受治疗性低温 (TH) 的缺氧缺血性脑病 (HIE) 患者的不良发育结局。设计 ≥ 35 周的 HIE/TH 新生儿在新生儿期 (n=46) 参加生理学研究，并且在 18 个月时死亡或接受神经发育随访 (n=43)。主要结果是死亡、脑瘫诊断或贝利婴儿发育评分 III <70 的任何组成部分的复合结果。我们假设三尖瓣环平面收缩偏移 (TAPSE) <6 mm 和/或 RV 面积变化分数 (RV-FAC) <0.29 可预测不良结果。结果 死亡9例，随访34例，平均年龄18.9±1.4个月。15 名 (35%) 患者的 RV 收缩性能指标均异常，4 名 (9%) 患者仅 TAPSE <6 mm 异常，5 名 (12%) 患者 (19%) 仅 RV-FAC <0.29 异常RV 功能正常）。尽管入院时相似，但 24 小时内有 RV 功能障碍的新生儿心血管和神经系统疾病的严重程度高于无严重 MRI 异常的新生儿（70% 对 53%，p=0.01）更常见。在逻辑回归中，TAPSE <6 mm（OR 3.6，95% CI 1.2 至 10.1；p=0.017）和脑部 MRI 异常 [OR 21.7，95% CI 1.4 至 336；p=0.028) 与不良结果独立相关。TAPSE <6 mm 预测结果的敏感性为 91%，特异性为 81%。结论 出生后心血管功能对接受 TH 治疗的 HIE 患者神经系统结局的作用值得进一步研究。在 24 小时内定量测量 RV 功能可能提供额外的神经学预后工具。可应合理要求提供数据。用于在这项工作中得出结论的数据可作为补充材料使用。有关进一步数据的讨论，请联系相应的作者。