El Amrousy Doaa, Adel Rowan, Ayoub Dalia, Rowisha Mohamed
Pediatric Department, Tanta University Hospital, Tanta, Egypt.
Pediatr Res. 2025 May 8. doi: 10.1038/s41390-025-04071-4.
Phototherapy of jaundiced neonates has several cardiovascular effects. We investigated the effect of phototherapy on cardiac function in jaundiced full-term neonates using two-dimensional speckle tracking echocardiography (2D-STE).
This cohort study was conducted on 40 full term neonates with unconjugated hyperbilirubinemia who needed phototherapy as the patient group and 40 healthy neonates of matched gestational age, age, and sex served as the control group. Conventional echocardiography, tissue Doppler, and 2D-STE were performed before and 24 h after phototherapy. Serum troponin T, serum bilirubin levels, systolic and diastolic blood pressure, and heart rate (HR) were measured also before and after phototherapy.
Systolic and diastolic blood pressure significantly decreased in the patient group after phototherapy compared to their levels before phototherapy. On the contrary, HR significantly increased after phototherapy in the patient group. However, serum cardiac troponin showed non-significant change after phototherapy. After phototherapy, all conventional and tissue Doppler parameters showed non-significant change. While 2D- left ventricular global longtudinal strain (2D-LVGLS) obtained by STE significantly decreased after phototherapy. There was a significant negative correlation between 2D-LV GLS and both duration and number of phototherapy units and both are good predictors for 2D-LVGLS.
Phototherapy may cause myocardial dysfunction that is correlated with the duration and number of phototherapy units.
Phototherapy of jaundiced neonates has many cardiovascular effects such as decrease in blood pressure and stroke volume. However, the effect of phototherapy on cardiac function in neonates has not been fully investigated yet. We investigated, for the first time, the effect of phototherapy on cardiac function in jaundiced full term neonates using two-dimensional speckle tracking echocardiography (2D-STE). Phototherapy may cause myocardial dysfunction that is correlated with the duration and number of phototherapy unit. Cardiac shield may be needed during phototherapy.
新生儿黄疸光疗具有多种心血管效应。我们使用二维斑点追踪超声心动图（2D - STE）研究了光疗对足月黄疸新生儿心脏功能的影响。
本队列研究选取了40例因未结合胆红素血症需要光疗的足月新生儿作为患者组，另选40例胎龄、年龄和性别匹配的健康新生儿作为对照组。在光疗前及光疗后24小时进行常规超声心动图、组织多普勒和2D - STE检查。同时在光疗前后测量血清肌钙蛋白T、血清胆红素水平、收缩压和舒张压以及心率（HR）。
与光疗前相比，患者组光疗后收缩压和舒张压显著降低。相反，患者组光疗后HR显著升高。然而，光疗后血清心肌肌钙蛋白无显著变化。光疗后，所有常规和组织多普勒参数均无显著变化。而通过STE获得的二维左心室整体纵向应变（2D - LVGLS）在光疗后显著降低。2D - LV GLS与光疗单位的持续时间和数量均呈显著负相关，二者都是2D - LVGLS的良好预测指标。
光疗可能导致心肌功能障碍，且与光疗单位的持续时间和数量相关。
新生儿黄疸光疗具有多种心血管效应，如血压和每搏输出量降低。然而，光疗对新生儿心脏功能的影响尚未得到充分研究。我们首次使用二维斑点追踪超声心动图（2D - STE）研究了光疗对足月黄疸新生儿心脏功能的影响。光疗可能导致心肌功能障碍，且与光疗单位的持续时间和数量相关。光疗期间可能需要心脏防护。
