Cardiac findings in newborn twins.
ECG
congenital heart disease
echocardiography
multiple pregnancy
Journal
Acta paediatrica (Oslo, Norway : 1992)
ISSN: 1651-2227
Titre abrégé: Acta Paediatr
Pays: Norway
ID NLM: 9205968
Informations de publication
Date de publication:
10 2023
10 2023
Historique:
revised:
22
11
2022
received:
27
09
2022
accepted:
12
12
2022
medline:
11
9
2023
pubmed:
14
12
2022
entrez:
13
12
2022
Statut:
ppublish
Résumé
To evaluate cardiac findings in newborn twins from the general population and investigate if newborn twins may require systematic evaluation of cardiac parameters. Prospective cohort study of newborns with cardiac evaluation performed during the first month of life. Cardiac findings were compared 1:3 with matched singletons. We included 412 newborn twins (16% monochorionic; 50% boys) and 1236 singletons. Comparing cardiac findings showed twins had an increased prevalence of non-severe structural heart disease (most common: ventricular septal defects in both groups), thinner left ventricular posterior wall in diastole (LVPWd; 1.82 vs. 1.87 mm, p = 0.02), smaller diameter of the left atrium (10.6 vs. 11.1 mm, p = 0.04), higher heart rate (148 vs. 144 bpm, p = 0.04), more left-shifted QRS axis (106 vs. 111°, p < 0.001), and lower maximum R-wave amplitude in V1 (927 vs. 1015 μV, p = 0.02) compared to singletons. After multifactorial adjustment for potential confounders, the effect of twinning on cardiac parameters persisted only for LVPWd (p < 0.05). Despite contemporary surveillance, we found an increased prevalence of non-severe structural heart disease in a population-based cohort of newborn twins. However, the effect of twinning on cardiac parameters was modest and generally did not persist after correction for likely confounding factors.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2050-2059Subventions
Organisme : Independent Research Fund Denmark
ID : 0134-00363B
Organisme : Novo Nordisk Foundation
ID : NNF20OC0065799
Organisme : The Candy Foundation
Organisme : The Capital Regions Research Council
Organisme : The Heart Foundation
Organisme : The Research Council at Herlev-Gentofte Hospital
Organisme : Toyota Foundation
Commentaires et corrections
Type : CommentIn
Informations de copyright
© 2022 The Authors. Acta Paediatrica published by John Wiley & Sons Ltd on behalf of Foundation Acta Paediatrica.
Références
Pinborg A. IVF/ICSI twin pregnancies: risks and prevention. Hum Reprod Update. 2005;11:575-593.
Oldenburg A, Rode L, Bødker B, et al. Influence of chorionicity on perinatal outcome in a large cohort of Danish twin pregnancies. Ultrasound Obstet Gynecol. 2012;39:69-74.
Panagiotopoulou O, Fouzas S, Sinopidis X, Mantagos SP, Dimitriou G, Karatza AA. Congenital heart disease in twins: the contribution of type of conception and chorionicity. Int J Cardiol. 2016;218:144-149.
Balasubramanian R, Vuppalapati S, Avanthika C, et al. Epidemiology, genetics and epigenetics of congenital heart diseases in twins. Cureus. 2021;13:e17253. doi:10.7759/cureus.17253
Sherer DM. Adverse perinatal outcome of twin pregnancies according to chorionicity: review of the literature. Am J Perinatol. 2001;18:23-37.
Best KE, Rankin J. Increased risk of congenital heart disease in twins in the north of England between 1998 and 2010. Heart. 2015;101:1807-1812.
Manning N. The influence of twinning on cardiac development. Early Hum Dev. 2008;84:173-179.
Pettit KE, Merchant M, Machin GA, Tacy TA, Norton ME. Congenital heart defects in a large, unselected cohort of monochorionic twins. J Perinatol. 2013;33:457-461.
Gijtenbeek M, Shirzada MR, Ten Harkel ADJ, Oepkes D, Haak MC. Congenital heart defects in monochorionic twins: a systematic review and meta-analysis. J Clin Med. 2019;8:1-10.
Bahtiyar MO, Dulay AT, Weeks BP, Friedman AH, Copel JA. Prevalence of congenital heart defects in monochorionic/diamniotic twin gestations: a systematic literature review. J Ultrasound Med. 2007;26:1491-1498.
Herskind AM, Pedersen DA, Christensen K. Increased prevalence of congenital heart defects in monozygotic and dizygotic twins. Circulation. 2013;128:1182-1188.
Hanson B, Tuna N, Bouchard T, et al. Genetic factors in the electrocardiogram and heart rate of twins reared apart and together. Am J Cardiol. 1989;63:606-609.
Havlik RJ, Garrison RJ, Fabsitz R, Feinleib M. Variability of heart rate, P-R, QRS and Q-T durations in twins. J Electrocardiol. 1980;13:45-48.
Christophersen IE, Budtz-Jørgensen E, Olesen MS, Haunsø S, Christensen K, Svendsen JH. Familial atrial fibrillation predicts increased risk of mortality: a study in Danish twins. Circ Arrhythm Electrophysiol. 2013;6:10-15.
Sillesen AS, Raja AA, Pihl C, et al. Copenhagen baby heart study: a population study of newborns with prenatal inclusion. Eur J Epidemiol. 2019;34:79-90.
Vøgg ROB, Basit S, Raja AA, et al. Cohort profile: the Copenhagen baby heart study (CBHS). Int J Epidemiol. 2022;50:1778-1779.
Sigurdsson TS, Lindberg L. Six commonly used empirical body surface area formulas disagreed in young children undergoing corrective heart surgery. Acta Paediatr. 2020;109:1838-1846.
Lopez L, Colan SD, Frommelt PC, et al. Recommendations for quantification methods during the performance of a pediatric echocardiogram: a report from the pediatric measurements writing Group of the American Society of echocardiography pediatric and congenital heart disease council. J Am Soc Echocardiogr. 2010;23:465-495.
Teichholz LE, Kreulen T, Herman MV, Gorlin R. Problems in echocardiographic volume determinations: echocardiographic-angiographic correlations in the presence or absence of asynergy. Am J Cardiol. 1976;37:7-11.
Paerregaard MM, Hvidemose SO, Pihl C, et al. Defining the normal QT interval in newborns: the natural history and reference values for the first 4 weeks of life. Europace. 2021;23:278-286.
Hartmann J, Paerregaard MM, Norsk J, et al. Gestational age and neonatal electrocardiograms. Pediatrics. 2021;148:e2021050942.
Adams TD, Yanowitz FG, Fisher AG, et al. Heritability of cardiac size: an echocardiographic and electrocardiographic study of monozygotic and dizygotic twins. Circulation. 1985;71:39-44.
Bielen E, Fagard R, Amery A. The inheritance of left ventricular structure and function assessed by imaging and Doppler echocardiography. Am Heart J. 1991;121:1743-1749.
Busjahn CA, Schulz-Menger J, Abdel-Aty H, et al. Heritability of left ventricular and papillary muscle heart size: a twin study with cardiac magnetic resonance imaging. Eur Heart J. 2009;30:1643-1647.
Noh HM, Lee SC, Park SW, Sung J, Song YM. Genetic influence on left ventricular structure and function: a Korean twin and family study. Twin Res Hum Genet. 2015;18:281-289.
Overbeek LIH, Kapusta L, Peer PGM, de Korte CL, Thijssen JM, Daniels O. New reference values for echocardiographic dimensions of healthy Dutch children. Eur J Echocardiogr. 2006;7:113-121.
Russell MW, Law I, Sholinsky P, Fabsitz RR. Heritability of ECG measurements in adult male twins. J Electrocardiol. 1998;30 Suppl:64-68. doi:10.1016/s0022-0736(98)80034-4
Sillesen AS, Pihl C, Raja AA, et al. Repeatability and reproducibility of neonatal echocardiography: the Copenhagen baby heart study. J Am Soc Echocardiogr. 2019;32:895-905.e2.
Knowles RL, Ridout D, Crowe S, et al. Ethnic and socioeconomic variation in incidence of congenital heart defects. Arch Dis Child. 2017;102:496-502.
Saarel EV, Granger S, Kaltman JR, et al. Electrocardiograms in healthy north American children in the digital age. Circ Arrhythm Electrophysiol. 2018;11:e005808.