Pena José Luiz Barros, da Silva Marconi Gomes, Faria Sanny Cristina Castro, Salemi Vera Maria Cury, Mady Charles, Baltabaeva Aigul, Sutherland George R
Maternidade Hilda Brandão, Santa Casa, Belo Horizonte, Brazil.
J Am Soc Echocardiogr. 2009 Apr;22(4):369-75. doi: 10.1016/j.echo.2008.12.007. Epub 2009 Feb 8.
Color Doppler myocardial imaging (CDMI) allows the calculation of local longitudinal or radial strain rate (SR) and strain (epsilon). The aims of this study were to determine the feasibility and reproducibility of longitudinal and radial SR and epsilon in neonates during the first hours of life and to establish reference values.
Data were obtained from 55 healthy neonates (29 male; mean age, 20 +/- 14 hours; mean birth weight, 3,174 +/- 374 g). Apical and parasternal views quantified regional longitudinal and radial SR and epsilon in differing ventricular wall segments. Values at peak systole, early diastole, and late diastole were calculated from the extracted curves. CDMI data acquired at 300 +/- 50 frames/s were analyzed offline. Three consecutive cardiac cycles were measured during normal respiration. The timing of specific systolic or diastolic regional events was determined. Multiple comparisons between walls and segments were made.
Left ventricular (LV) longitudinal deformation showed basal differences compared with apical segments within one specific wall. Right ventricular (RV) longitudinal deformation was not homogeneous, with significant differences between basal and apical segments. Longitudinal epsilon values were higher in the RV free basal and middle wall segments compared with the left ventricle. In the RV free wall apical segment, longitudinal SR and epsilon were maximal. LV systolic SR and epsilon values were higher radially compared with longitudinally (radial peak systolic SR midportion, 2.9 +/- 0.6 s(-1); radial peak systolic epsilon, 53.8 +/- 19%; longitudinal peak systolic SR midportion, -1.8 +/- 0.5 s(-1); longitudinal peak systolic epsilon, -24.8 +/- 3%; P < .01). Longitudinal systolic epsilon and SR interobserver variability values were 1.2% and 0.7%, respectively.
Ultrasound-based SR and epsilon imaging is a practical and reproducible clinical technique in neonates, allowing the calculation of regional longitudinal and radial deformation in RV and LV segments. These regional SR and epsilon indices represent new, noninvasive parameters that can quantify normal neonate regional cardiac function. Independent from visual interpretation, they can be used as reference values for diagnosis in ill neonates.
彩色多普勒心肌成像（CDMI）可用于计算局部纵向或径向应变率（SR）和应变（ε）。本研究的目的是确定出生后最初几小时内新生儿纵向和径向SR及ε的可行性和可重复性，并建立参考值。
数据来自55名健康新生儿（29名男性；平均年龄，20±14小时；平均出生体重，3174±374克）。经心尖和胸骨旁视图对不同心室壁节段的局部纵向和径向SR及ε进行量化。从提取的曲线计算出收缩期峰值、舒张早期和舒张晚期的值。以300±50帧/秒采集的CDMI数据进行离线分析。在正常呼吸期间测量三个连续心动周期。确定特定收缩期或舒张期局部事件的时间。对不同壁和节段进行多次比较。
在同一特定壁内，左心室（LV）纵向变形显示基底部与心尖节段存在差异。右心室（RV）纵向变形不均匀，基底部和心尖节段之间存在显著差异。与左心室相比，右心室游离基底部和中间壁节段的纵向ε值更高。在右心室游离壁心尖节段，纵向SR和ε最大。左心室收缩期SR和ε值在径向上高于纵向（径向收缩期峰值SR中部，2.9±0.6 s⁻¹；径向收缩期峰值ε，53.8±19%；纵向收缩期峰值SR中部，-1.8±0.5 s⁻¹；纵向收缩期峰值ε，-24.8±3%；P<.01）。纵向收缩期ε和SR观察者间变异值分别为1.2%和0.7%。
基于超声的SR和ε成像在新生儿中是一种实用且可重复的临床技术，可用于计算右心室和左心室节段的局部纵向和径向变形。这些局部SR和ε指标代表了新的无创参数，可量化正常新生儿局部心脏功能。独立于视觉解读，它们可作为患病新生儿诊断的参考值。
