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充血性心力衰竭儿科患者的收缩和舒张功能

Systolic and Diastolic Function in Congestive Heart Failure Pediatric Patients.

作者信息

Butnariu Angela, Zamfir Camelia, Iancu Mihaela, Iacob Daniela, Samasca G, Lupan Iulia

出版信息

Rom J Intern Med. 2016 Jan-Mar;54(1):37-46. doi: 10.1515/rjim-2016-0004.

Abstract

BACKGROUND AND AIMS

Two-dimensional (2D) and Doppler echocardiography are the main methods for the non-invasive evaluation of ventricular function in children. Our study monitored the evaluation of systolic and diastolic function in pediatric patients, using classical echocardiographic parameters and pulsed tissue Doppler parameters, as well as the correlation between these.

METHODS

The study included 18 healthy children and 9 children diagnosed with congestive heart failure secondary to congenital heart malformations. The parameters of systolic and diastolic function were measured by 2D echocardiography, 2D guided M mode, color and pulsed Doppler, as well as by pulsed tissue Doppler at the level of the mitral and tricuspid annulus.

RESULTS

A relaxation alteration pattern or a pseudonormal pattern of E diastolic velocity compared to the A wave was found (E = A; E > A) in the group of subjects with heart failure. E wave deceleration time had significantly increased values in the case of patients with CHF, being correlated with diastolic dysfunction. Left ventricular flow propagation velocity Vp was decreased in patients with heart failure, the E/Vp ratio being maintained relatively constant in subjects with congestive heart failure and healthy subjects, most probably on account of the concomitant change in the E wave. Associations between the severity of systolic dysfunction and the diastolic dysfunction were found in pediatric patients diagnosed with congestive heart failure (Student test, p < 0.05).

CONCLUSIONS

Tissue Doppler measurements proved to be useful for the evaluation of pediatric patients with altered ventricular geometry secondary to congenital heart disease, systolic-diastolic dysfunction and heart failure.

摘要

背景与目的

二维(2D)及多普勒超声心动图是儿童心室功能无创评估的主要方法。我们的研究使用经典超声心动图参数和脉冲组织多普勒参数监测儿科患者的收缩和舒张功能评估,以及它们之间的相关性。

方法

该研究纳入了18名健康儿童和9名诊断为先天性心脏畸形继发充血性心力衰竭的儿童。通过二维超声心动图、二维引导M型、彩色和脉冲多普勒以及二尖瓣和三尖瓣环水平的脉冲组织多普勒测量收缩和舒张功能参数。

结果

在心力衰竭患者组中发现舒张期E波速度与A波相比呈松弛改变模式或假性正常模式(E = A;E > A)。CHF患者的E波减速时间值显著增加,与舒张功能障碍相关。心力衰竭患者的左心室血流传播速度Vp降低,充血性心力衰竭患者和健康受试者的E/Vp比值保持相对恒定,这很可能是由于E波的伴随变化。在诊断为充血性心力衰竭的儿科患者中发现收缩功能障碍的严重程度与舒张功能障碍之间存在关联(Student检验,p < 0.05)。

结论

组织多普勒测量被证明对评估先天性心脏病继发心室几何形状改变、收缩-舒张功能障碍和心力衰竭的儿科患者有用。

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