Multicenter Prospective PDA and Left Atrial Size Evaluation (PLASE) Study

2017 Fiscal Year Final Research Report

• Project/Area Number: 15K09735
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Embryonic/Neonatal medicine
• Research Institution: Kanagawa Children's Medical Center (Clinical Research Institute)
• Principal Investigator: TOYOSHIMA KATSUAKI 地方独立行政法人神奈川県立病院機構神奈川県立こども医療センター(臨床研究所), 臨床研究所, 部長 (50307542)
• Co-Investigator(Renkei-kenkyūsha): MASUTANI Satoshi 埼玉医科大学, 総合医療センター・小児科, 准教授 (10316739)
• Research Collaborator: KOBAYASHI Tohru 国立研究開発法人国立成育医療研究センター, 開発企画部臨床研究企画室, 室長 ; ISAYAMA Tetsuya 国立研究開発法人国立成育医療研究センター, 新生児科, 医長
• Project Period (FY): 2015-04-01 – 2018-03-31
• Keywords: 早産児 / 低出生体重児 / 動脈管開存症 / 手術 / 心臓超音波検査 / 左房容積

Outline of Final Research Achievements

We hypothesized that some echocardiographic indices might be useful for predicting the necessity of surgical closure of the PDA. We prospectively acquired clinical and echocardiographic data of infants with gestational ages between 23 and 29 weeks in 34 Japanese NICUs over 14 months. Data points were 1, 3, 7 and 14 days of age, and if applicable, before pharmacological or surgical closure of the PDA. We assessed left ventricular end-diastolic diameter, ratio of the left atrium to aorta diameter, left atrial volume (LAV), left pulmonary artery end-diastolic velocity, and PDA diameter (PDAd). In total, 691 patients were analyzed, of whom 61 (8.8%) underwent surgery after full consideration of clinical conditions and data. Worsening of all five echo indices was significantly associated with undergoing PDA surgical closure.
In conclusions, PDAd as well as the indices of LA and LV dilation may serve as useful indices for assessing the necessity of PDA surgical closure in preterm infants.

Free Research Field

新生児学