Biventricular adaptation after patent ductus arteriosus ligation.

Patent ductus arteriosus closure is followed by major adaptive changes in cardiac loading conditions, which may be associated with hemodynamic instability in some patients secondary to left ventricular systolic and diastolic dysfunction. Conventional echocardiography measures, including ejection fraction, have poor sensitivity for early detection of impaired left ventricular dysfunction. Speckle Tracking Echocardiography, which allows characterization of atrial and ventricular strain, may be an earlier and more sensitive marker of abnormal heart function. Recent guidelines suggest incorporation of speckle tracking echocardiography into multiparametric assessments of heart function in neonates. Its use may enhance clinical decision-making by improving early detection of dysfunction and enabling more accurate risk stratification following PDA closure.