Neonatal and Intensive Care Department, Medical University of Warsaw, Warsaw, Poland
Perinatal Cardiology Unit, Medical University of Warsaw, Warsaw, Poland
Kardiol Pol. 2019 Jan 13;77(4):445-450. doi: 10.5603/KP.a2019.0040. Epub 2019 Feb 27.
BACKGROUND Both gestational and chronological age of the neonate may influence and impair the function of the delicate and immature myocardium. However, the transition from fetal to neonatal circulation in preterm neonates is poorly understood. AIMS This study aimed to compare left ventricular (LV) systolic and diastolic function between premature neonates at expected term and term neonates during the postnatal cardiovascular transitional period. METHODS Using echocardiography, we assessed systolic and diastolic function of the LV in 89 preterm neonates at week 40 of postconceptional age and 29 term neonates after closure of the patent ductus arteriosus (PDA) and on the 28th day of life. Based on M‑mode images, we measured myocardial thickness and fractional shortening (FS%). Using pulsed‑wave Doppler echocardiography, we estimated cardiac output, myocardial performance index (MPI), and LV diastolic function (E and A waves, E/A ratio). Systolic and diastolic function was also assessed by tissue Doppler imaging. RESULTS Compared with term neonates on the 28th day of life, preterm neonates had reduced myocardial thickness (P ≤0.04), FS% (P = 0.002), and cardiac output (P = 0.01). However, preterm neonates had a lower MPI than term neonates after PDA closure (P <0.001) and on the 28th day of life (P = 0.02). The E/A ratio and S' wave values were similar in preterm and term neonates (P >0.05). CONCLUSIONS Preterm neonates at 40 weeks of postconceptional age have preserved systolic and diastolic function of the LV.
新生儿的胎龄和实际年龄都可能影响和损害娇嫩不成熟的心肌功能。然而，早产儿从胎儿循环向新生儿循环的转变过程还不太清楚。目的：本研究旨在比较预期足月的早产儿和出生后心血管过渡期的足月儿之间左心室（LV）收缩和舒张功能。方法：使用超声心动图评估 89 例孕龄 40 周的早产儿和 29 例动脉导管未闭（PDA）关闭后及出生后第 28 天的足月儿的 LV 收缩和舒张功能。根据 M 型图像测量心肌厚度和缩短分数（FS%）。使用脉冲波多普勒超声心动图估计心输出量、心肌性能指数（MPI）和 LV 舒张功能（E 和 A 波、E/A 比值）。还通过组织多普勒成像评估收缩和舒张功能。结果：与出生后第 28 天的足月儿相比，早产儿的心肌厚度（P ≤0.04）、FS%（P = 0.002）和心输出量（P = 0.01）降低。然而，与 PDA 关闭后和出生后第 28 天的足月儿相比，早产儿的 MPI 较低（P <0.001）。早产儿和足月儿的 E/A 比值和 S'波值相似（P >0.05）。结论：孕龄 40 周的早产儿左心室收缩和舒张功能正常。
