Ludman P, Foale R, Alexander N, Nihoyannopoulos P
Department of Medicine, Hammersmith Hospital, London.
Br Heart J. 1990 Jun;63(6):355-61. doi: 10.1136/hrt.63.6.355.
To identify the echocardiographic features that can be used to distinguish between hypoplastic left heart syndrome and other causes of right ventricular overload in the sick neonate cross sectional echocardiographic studies of 10 neonates with hypoplastic left heart syndrome were analysed and compared with those in 15 neonates with other causes of right ventricular overload and 15 normal controls. Left ventricular and right ventricular cavity dimensions and the shape and size of the mitral valve annulus and aortic root were recorded and presented both as absolute values (mm) and corrected for body surface area (mm/m2). Logistic regression was used to produce a classification rule to estimate the probability of a neonate having hypoplastic left heart syndrome. The diameter of the mitral valve annulus was the single most discriminative variable. There was, however, considerable overlap of all the calculated features between neonates with hypoplastic left heart syndrome and those with other causes of right ventricular overload. The diagnosis of hypoplastic left heart syndrome should not be based on any one single echocardiographic feature but the general appearance of abnormal left heart valves, small cavity dimensions, and the size of the mitral valve annulus.
为了确定可用于区分新生儿期患病婴儿的左心发育不全综合征与其他右心室负荷过重病因的超声心动图特征，分析了10例左心发育不全综合征新生儿的横断面超声心动图研究结果，并与15例因其他病因导致右心室负荷过重的新生儿以及15例正常对照的研究结果进行比较。记录左心室和右心室腔尺寸以及二尖瓣环和主动脉根部的形状和大小，并以绝对值（mm）表示，同时校正体表面积（mm/m²）。采用逻辑回归生成分类规则，以估计新生儿患左心发育不全综合征的概率。二尖瓣环直径是最具鉴别性的单一变量。然而，左心发育不全综合征新生儿与其他右心室负荷过重病因新生儿之间，所有计算特征均存在相当程度的重叠。左心发育不全综合征的诊断不应基于任何单一的超声心动图特征，而应依据左心瓣膜异常的总体表现、小腔室尺寸以及二尖瓣环大小。
