Echocardiographic predictors of poor prognosis in congenital diaphragmatic hernia

Background/purpose The purpose of this study was to investigate echocardiographic parameters in relation to the outcomes of isolated left-sided congenital diaphragmatic hernia (CDH). Methods This multicenter, retrospective, observational study was conducted among patients with CDH born between 2006 and 2010. Patients in this study did not have severe cardiac malformations or chromosomal aberrations. Patients with incomplete echocardiographic examinations were excluded. In total, 84 patients with left-sided isolated CDH were included in this study. The prognostic parameters were obtained from postnatal echocardiographic images within 24 h after birth. Results Eight patients died before 90 days of birth. Univariate analysis showed that the presence of continuous right to left shunt at the ductus, left pulmonary artery diameter of < 2.7 mm, right pulmonary artery diameter of < 3.3 mm, and left ventricular diastolic diameter of < 10.8 mm, were the predictors of poor prognosis. Multivariate logistic regression analysis showed that right pulmonary artery diameter of < 3.3 mm (adjusted OR 10.28, 95% C.I.: 1.15–249.19) and left ventricular diastolic diameter of < 10.8 mm (adjusted OR 7.86, 95% C.I.: 1.01–82.82) were predictors of poor prognosis. Conclusions This study revealed that the predictors of poor prognosis associated with CDH include smaller right pulmonary artery and left ventricular diastolic diameters. Retrospective Study-Level II.