Wei Yi, Xu JianXin, Xu Ting, Fan Jing, Tao ShaoYing
Department of Pediatrics, Jin Hua Municipal Central Hospital, Jin Hua, Zhejiang 321000, China.
Pediatr Cardiol. 2009 Aug;30(6):741-6. doi: 10.1007/s00246-009-9421-6. Epub 2009 Apr 2.
The aim of the study was to evaluate the left ventricular systolic function of newborns with asphyxia using tissue Doppler imaging (TDI). Newborns with a history of asphyxia were divided into severe and mild groups based on their Apgar scores; normal newborns without asphyxia served as the controls. Left ventricular ejection fraction (LVEF), fraction shortening (FS), and stroke volume (SV) were measured by M-mode echocardiography at 24, 48, and 72 h after birth. The peak systolic velocity of the anterior mitral valve leaflet (Sm wave) was measured with TDI. Cardiac troponin I (CTnI) was measured. The results revealed that the LVEF and FS of the severe asphyxia group at 24 h were significantly lower than those at later time points (P < 0.01). These parameters were also significantly lower than those of the mild and control groups (P < 0.01). SV was not significantly different among the three groups. Sm wave of asphyxia groups was significantly lower than that of control group (P < 0.001). In the severe asphyxia group, Sm wave at 24 h was significantly lower than that at 48 or 72 h (P < 0.001). CTnI values of the severe asphyxia group were remarkably higher than those of the other two groups (P < 0.01). The findings of this study indicate decreased left ventricular systolic function of newborn children after asphyxia. Sm by TDI is a more sensitive indicator of left ventricular systolic function than LVEF, FS, or SV by M-mode echocardiography.
本研究旨在使用组织多普勒成像(TDI)评估窒息新生儿的左心室收缩功能。有窒息病史的新生儿根据其阿氏评分分为重度和轻度组;无窒息的正常新生儿作为对照组。出生后24、48和72小时通过M型超声心动图测量左心室射血分数(LVEF)、缩短分数(FS)和每搏输出量(SV)。用TDI测量二尖瓣前叶的收缩期峰值速度(Sm波)。测量心肌肌钙蛋白I(CTnI)。结果显示,重度窒息组24小时时的LVEF和FS显著低于后期时间点(P<0.01)。这些参数也显著低于轻度组和对照组(P<0.01)。三组间SV无显著差异。窒息组的Sm波显著低于对照组(P<0.001)。在重度窒息组中,24小时时的Sm波显著低于48或72小时时(P<0.001)。重度窒息组的CTnI值显著高于其他两组(P<0.01)。本研究结果表明窒息后新生儿左心室收缩功能降低。与M型超声心动图测量的LVEF、FS或SV相比,TDI测量的Sm是左心室收缩功能更敏感的指标。