早产儿左心室几何形态改变的危险因素及预后意义
Risk factors and prognostic significance of altered left ventricular geometry in preterm infants.
作者信息
Choudhry Swati, Salter Amber, Cunningham Tyler W, Levy Philip T, Hackett Brian P, Singh Gautam K, Johnson Mark C
机构信息
Department of Pediatrics, Washington University School of Medicine, Saint Louis, MO, USA.
Department of Biostatistics, Washington University School of Medicine, Saint Louis, MO, USA.
出版信息
J Perinatol. 2018 May;38(5):543-549. doi: 10.1038/s41372-018-0047-5. Epub 2018 Feb 6.
OBJECTIVE
Left ventricular (LV) hypertrophy (LVH) predicts adverse cardiac events in adults. We sought to determine the risk factors and prognostic significance of altered LV geometry in preterm infants.
STUDY DESIGN
In an echocardiographic, single-center, retrospective case-control study we investigated the risk factors and outcomes in patients with altered LV geometry (either increased left ventricular mass index (LVMI) or increased relative wall thickness (RWT)) from a cohort of 503 preterm infants ≤2 kg.
RESULT
Altered LV geometry was seen in 180 patients and was predicted by postnatal steroids and small for gestational age. Hospital stay was longer in the elevated RWT cases. Altered LV geometry resolved in 129 of the 131 cases with follow-up echocardiogram. Fifteen of 94 patients with elevated RWT died compared to 3/90 controls (P = 0.004).
CONCLUSION
Altered LV geometry in preterm infants is associated with postnatal steroid use and small for gestational age. Elevated RWT is associated with longer hospital stay and increased mortality.
目的
左心室（LV）肥厚（LVH）可预测成人心脏不良事件。我们试图确定早产儿左心室几何形态改变的危险因素及预后意义。
研究设计
在一项超声心动图单中心回顾性病例对照研究中，我们调查了来自503例体重≤2千克的早产儿队列中左心室几何形态改变（左心室质量指数（LVMI）增加或相对壁厚度（RWT）增加）患者的危险因素及预后情况。
结果
180例患者出现左心室几何形态改变，其预测因素为出生后使用类固醇和小于胎龄。RWT升高的病例住院时间更长。131例行超声心动图随访的病例中，129例左心室几何形态改变得到缓解。94例RWT升高的患者中有15例死亡，而对照组90例中有3例死亡（P = 0.004）。
结论
早产儿左心室几何形态改变与出生后使用类固醇及小于胎龄有关。RWT升高与住院时间延长及死亡率增加有关。
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