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Objectives: To assess the feasibility, accuracy, and reproducibility of tissue‐tracking mitral annular displacement (TMAD) compared with other measures of left ventricular systolic function in healthy preterm and term neonates in the transitional period. Methods: This was a prospective observational study. Two echocardiograms were performed at 24 and 48 hours of life. TMAD, shortening fraction (SF), ejection fraction (EF), s′, and global longitudinal strain (GLS) were measured offline. Accuracy to detect impaired GLS was tested by ROC curve analysis. DeLong test was used to compare AUCs. Intra and interobserver reproducibility of the off‐line analysis was calculated. Results: Mean ± SD gestational age and weight were 34.2 ± 3.8 weeks and 2162 ± 833 g, respectively. TMAD was feasible in 168/180 scans (93%). At 24 hours the AUC (95% CI) of SF, EF, s′, and TMAD (%) was 0.51 (0.36–0.67), 0.68 (0.54–0.82), 0.63 (0.49–0.77), and 0.89 (0.79–0.99) respectively. At 48 hours the AUC (95% CI) of SF, EF, s′, and TMAD (%) was 0.64 (0.51–0.77), 0.59 (0.37–0.80), 0.70 (0.54–0.86), and 0.96 (0.91–1.00), respectively. The AUC of TMAD was superior to the AUC of SF, EF, s′, at both timepoints (P <.02). Intraclass correlation coefficients (95% CI) of intra and interobserver reproducibility of TMAD were 0.97 (0.95–0.99) and 0.94 (0.88–0.97), respectively. Conclusion: TMAD showed improved accuracy and optimal reproducibility in neonates in the first 48 hours of life. [ABSTRACT FROM AUTHOR]

Objectives: To assess reproducibility and accuracy of left ventricular output (LVO) quantifications in neonates, when left ventricular outflow tract diameter (LVOTD) was measured at the hinges of the aortic valve (AV), at the aortic sinus (AS), and at the sinotubular junction (STJ). Methods: This was an observational study. In the first cohort of very preterm neonates, we assessed intraobserver and interobserver repeatability of LVOTD measured at the AV, AS, and STJ and of the corresponding LVO. In the second cohort of older neonates, we compared paired LVO measurements by echo and magnetic resonance imaging (MRI). Results: In the first cohort of 48 neonates, mean (standard deviation) weight and age at scan were 1046 (302) g and 28.1 (2.7) weeks. Interobserver bias (95% limits of agreement [LOA]) for LVOTD at the AV, AS, and STJ was 0 (−0.3 to 0.3) mm, 0 (−0.7 to 0.7) mm, and 0 (−0.8 to 0.7) mm, respectively. Interobserver bias (95% LOA) for the corresponding LVO was −1.3 (−31 to 33) ml/kg/min, −0.5 (−88 to 87) ml/kg/min, and −7.2 (−83 to 69) ml/kg/min, respectively. In the second cohort of 10 neonates, median (range) weight and age at scan were 1942 (970–3640) g and 37.2 (31.7–39.8) weeks. LVO measured at the AV showed stronger agreement with MRI: bias (LOA) −10.6 (−74 to 52) ml/kg/min, compared to LVO measured at AS and STJ: 194 (−0.5 to 388) ml/kg/min and 43 (−72 to 159) ml/kg/min respectively. Conclusions: Reproducibility and accuracy of LVO quantification by echo were better when aortic diameter was measured at AV. [ABSTRACT FROM AUTHOR]