Congenital diaphragmatic hernia-associated cardiac dysfunction

Semin Perinatol. 2020 Feb;44(1):151168. doi: 10.1053/j.semperi.2019.07.007. Epub 2019 Jul 30.

Abstract

There is increasing evidence that cardiac dysfunction is a key contributor to CDH pathophysiology. Dysfunction in both right and left ventricles is common in the early neonatal period, contributes to clinical disease severity, and is associated with adverse outcomes including death and ECMO use. Early and routine assessment of ventricular function and pulmonary artery pressure may guide individualized clinical decision-making, including use of pulmonary vasodilators, cardiotropes, ECMO, and timing of surgical repair. Minimizing cardiac dysfunction, whether by prenatal, postnatal or perinatal treatment strategies, may lead to improved outcome in CDH.

Keywords: Cardiac function; Congenital diaphragmatic hernia; Echocardiography; Pulmonary hypertension; Ventricular function.

Publication types

  • Review

MeSH terms

  • Cardiotonic Agents / therapeutic use
  • Echocardiography
  • Extracorporeal Membrane Oxygenation
  • Hernias, Diaphragmatic, Congenital / complications
  • Hernias, Diaphragmatic, Congenital / physiopathology*
  • Hernias, Diaphragmatic, Congenital / surgery
  • Humans
  • Hypertension, Pulmonary / diagnostic imaging
  • Hypertension, Pulmonary / drug therapy
  • Hypertension, Pulmonary / etiology
  • Hypertension, Pulmonary / physiopathology*
  • Infant, Newborn
  • Lung / abnormalities
  • Plastic Surgery Procedures
  • Vascular Resistance
  • Vasodilator Agents / therapeutic use
  • Ventricular Dysfunction / diagnostic imaging
  • Ventricular Dysfunction / drug therapy
  • Ventricular Dysfunction / etiology
  • Ventricular Dysfunction / physiopathology*

Substances

  • Cardiotonic Agents
  • Vasodilator Agents