van Ark Allard E, Molenschot Mirella C, Wesseling Maria H, de Vries Willem B, Strengers Jan L M, Adams Arthur, Breur Johannes M P J
Department of Pediatric Cardiology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, the Netherlands.
Department of Neonatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, the Netherlands.
Neonatology. 2018;114(3):198-204. doi: 10.1159/000488387. Epub 2018 Jun 25.
With the increasing incidence of births of very preterm very-low-birth-weight infants, there is a demand for echocardiographic reference values of cardiac dimensions.
The aim of this study was to provide reference values of cardiac valve annulus diameters in a cohort of extremely preterm very-low-birth-weight neonates and to correlate these with patient characteristics.
Valve diameters of 376 infants of < 32 weeks' gestation and with a birth weight of ≤2,000 g were measured using 2-dimensional echocardiography. Correlations between valve diameters and patient characteristics (birth length/weight, body surface area, gestational age, and sex) were assessed. Birth weight was used to establish linear regression models. Inter- and intraobserver agreement was assessed through intraclass correlation coefficient (ICC) analysis.
Substantial variability was found (aortic valve mean [standard deviation; range]: 5.0 mm [0.6; 3.7-6.5]; pulmonic valve: 5.8 mm [0.8; 3.4-7.9]; mitral valve: 8.0 mm [1.0; 5.5-10.5]; tricuspid valve: 7.6 mm [1.2; 4.9-10.6]). There was a moderate correlation between birth weight and valve diameter (R2 aortic valve: 0.36; pulmonic valve: 0.20; mitral valve: 0.24; tricuspid valve: 0.24). Adequate intraobserver (ICC range 0.74-0.91) and interobserver agreement (ICC range 0.77-0.89) was found.
Our study provides ready-to-use reference values for cardiac valve annulus diameters for extremely preterm infants.
随着极早早产极低出生体重儿出生率的增加，对心脏尺寸的超声心动图参考值有了需求。
本研究的目的是提供一组极早早产极低出生体重新生儿心脏瓣膜环直径的参考值，并将这些值与患者特征相关联。
使用二维超声心动图测量376例孕周小于32周且出生体重≤2000g的婴儿的瓣膜直径。评估瓣膜直径与患者特征（出生身长/体重、体表面积、孕周和性别）之间的相关性。使用出生体重建立线性回归模型。通过组内相关系数（ICC）分析评估观察者间和观察者内的一致性。
发现存在显著变异性（主动脉瓣平均值[标准差；范围]：5.0mm[0.6；3.7 - 6.5]；肺动脉瓣：5.8mm[0.8；3.4 - 7.9]；二尖瓣：8.0mm[1.0；5.5 - 10.5]；三尖瓣：7.6mm[1.2；4.9 - 10.6]）。出生体重与瓣膜直径之间存在中度相关性（R²主动脉瓣：0.36；肺动脉瓣：0.20；二尖瓣：0.24；三尖瓣：0.24）。发现观察者内（ICC范围0.74 - 0.91）和观察者间具有足够的一致性（ICC范围0.77 - 0.89）。
我们的研究为极早早产儿的心脏瓣膜环直径提供了现成的参考值。
