Broadhouse Kathryn M, Finnemore Anna E, Price Anthony N, Durighel Giuliana, Cox David J, Edwards Anthony David, Hajnal Joseph V, Groves Alan M
J Cardiovasc Magn Reson. 2014 Jul 23;16(1):54. doi: 10.1186/s12968-014-0054-4.
BACKGROUND: Many pathologies seen in the preterm population are associated with abnormal blood supply, yet robust evaluation of preterm cardiac function is scarce and consequently normative ranges in this population are limited. The aim of this study was to quantify and validate left ventricular dimension and function in preterm infants using cardiovascular magnetic resonance (CMR). An initial investigation of the impact of the common congenital defect patent ductus arteriosus (PDA) was then carried out. METHODS: Steady State Free Procession short axis stacks were acquired. Normative ranges of left ventricular end diastolic volume (EDV), stroke volume (SV), left ventricular output (LVO), ejection fraction (EF), left ventricular (LV) mass, wall thickness and fractional thickening were determined in "healthy" (control) neonates. Left ventricular parameters were then investigated in PDA infants. Unpaired student t-tests compared the 2 groups. Multiple linear regression analysis assessed impact of shunt volume in PDA infants, p-value ≤ 0.05 being significant. RESULTS: 29 control infants median (range) corrected gestational age at scan 34+6(31+1-39+3) weeks were scanned. EDV, SV, LVO, LV mass normalized by weight and EF were shown to decrease with increasing corrected gestational age (cGA) in controls. In 16 PDA infants (cGA 30+3(27+3-36+1) weeks) left ventricular dimension and output were significantly increased, yet there was no significant difference in ejection fraction and fractional thickening between the two groups. A significant association between shunt volume and increased left ventricular mass correcting for postnatal age and corrected gestational age existed. CONCLUSION: CMR assessment of left ventricular function has been validated in neonates, providing more robust normative ranges of left ventricular dimension and function in this population. Initial investigation of PDA infants would suggest that function is relatively maintained.
背景:早产儿中出现的许多病症都与异常的血液供应有关,但对早产心脏功能的有力评估却很少,因此该人群的正常范围有限。本研究的目的是使用心血管磁共振成像(CMR)对早产儿的左心室尺寸和功能进行量化和验证。随后对常见先天性缺陷动脉导管未闭(PDA)的影响进行了初步研究。 方法:采集稳态自由进动短轴图像。在“健康”(对照)新生儿中确定左心室舒张末期容积(EDV)、每搏输出量(SV)、左心室输出量(LVO)、射血分数(EF)、左心室(LV)质量、壁厚和增厚分数的正常范围。然后对患有PDA的婴儿的左心室参数进行研究。采用非配对学生t检验比较两组。多元线性回归分析评估分流体积对患有PDA婴儿的影响,p值≤0.05具有统计学意义。 结果:对29名对照婴儿(扫描时的中位(范围)校正胎龄为34 + 6(31 + 1 - 39 + 3)周)进行了扫描。对照中,EDV、SV、LVO、经体重标准化的LV质量和EF显示随着校正胎龄(cGA)的增加而降低。在16名患有PDA的婴儿(cGA 30 + 3(27 + 3 - 36 + 1)周)中,左心室尺寸和输出量显著增加,但两组之间的射血分数和增厚分数没有显著差异。存在分流体积与校正出生后年龄和校正胎龄后的左心室质量增加之间的显著关联。 结论:CMR对左心室功能的评估已在新生儿中得到验证,为该人群提供了更可靠的左心室尺寸和功能正常范围。对患有PDA婴儿的初步研究表明其功能相对得以维持。
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