Perinatal asphyxia and left ventricular mass: Redefining cardiac assessment

Table 1 Comprehensive summary of key findings

Parameter/finding	Asphyxia group (n = 84)	Control group (n = 48)	Statistical result	Clinical significance
Primary LV mass comparison
Mean LV mass (g)	7.9 ± 2.3	10.1 ± 0.7	P = 0.001	Significantly reduced in asphyxia
%below controls threshold	63% of cases	Reference		Majority experience LV mass reduction
LV mass by asphyxia severity (Sarnat criteria)
Mild asphyxia	7.8 ± 2.3 g		ANOVA P = 0.289	Lower than controls despite mild injury
Moderate asphyxia	8.8 ± 2.5 g		Dose-response trend	Progressive LV mass decline with severity
Severe asphyxia	7.1 ± 1.5 g		Lowest LV mass	Most pronounced structural compromise
Correlation of LV mass with clinical parameters
Birth weight	Moderate positive correlation		r = 0.610, P = 0.001	Growth-restricted infants at higher cardiac risk
Gestational age	Weak positive correlation		r = 0.269, P = 0.028	Preterm infants more vulnerable
Sex (male vs female)	Trend toward higher LV mass in males		Not statistically significant	Larger studies needed; sexual dimorphism possible
Temporal changes in LV mass (days 1-3)
Day 1 of life	8.1 ± 2.5 g (highest)		ANOVA P = 0.728	Critical assessment window on day 1
Day 2 of life	7.7 g		Declining trend	Progressive deterioration over 72 hours
Day 3 of life	7.7 g		Plateau	Serial echocardiography recommended
Echocardiographic & methodological features
Assessment method	M-mode echo, Devereux formula, EACVI guidelines	Same protocol	Gold standard non-invasive tool	POCUS feasible in resource-limited settings
Study design	Hospital-based cross-sectional, Enugu Nigeria	Matched controls	n = 84 vs n = 48	Single-center; needs multicenter validation
Comparison with literature
Pakistani study (166 term neonates)	Pulmonary HTN 50%; PDA 37.2%		aOR severe asphyxia = 5.01	Confirms high cardiac morbidity in asphyxia
Vijayashankar et al[52]	11/69 neonates had LV dysfunction		Approximately 16% prevalence	Asphyxia is a leading cause of LV dysfunction
Myocardial dysfunction (HIE study)	53.3% of HIE cases had myocardial dysfunction		CK-MB, Troponin I correlated with severity	Biochemical + echo markers complement each other

LV: Left ventricular; EACVI: European Association of Cardiovascular Imaging; HTN: Hypertension; PDA: Patent ductus arteriosus; HIE: Hypoxic-ischemic encephalopathy; aOR: Adjusted odds ratio; CK-MB: Creatine kinase-MB; POCUS: Point of care ultrasound.