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应用组织多普勒成像评估窒息新生儿的左心室收缩功能。

Left ventricular systolic function of newborns with asphyxia evaluated by tissue Doppler imaging.

作者信息

Wei Yi, Xu JianXin, Xu Ting, Fan Jing, Tao ShaoYing

机构信息

Department of Pediatrics, Jin Hua Municipal Central Hospital, Jin Hua, Zhejiang 321000, China.

出版信息

Pediatr Cardiol. 2009 Aug;30(6):741-6. doi: 10.1007/s00246-009-9421-6. Epub 2009 Apr 2.

DOI:10.1007/s00246-009-9421-6
PMID:19340476
Abstract

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.

摘要

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。

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