Department of Pediatric Cardiology, University of Nebraska College of Medicine and Children's Hospital and Medical Center, Omaha, NE, USA.
Department of Mechanical Engineering, Purdue University, West Lafayette, IN, USA.
Pediatr Res. 2021 Mar;89(4):987-995. doi: 10.1038/s41390-020-1011-6. Epub 2020 Jun 22.
We implemented sophisticated color M-mode analysis to assess age-dependent progression of left ventricular (LV) diastolic function.
Normal infants were prospectively enrolled for serial echocardiograms at 1 week, 1 month, 6 months, 1 year, and 2 years. From color M-mode scans, propagation velocity (V), strength of filling (V), and intraventricular pressure difference (IVPD) in 3 segments along apex-to-mitral valve scan line were measured.
Age-wise comparisons of diastolic filling from 121 echocardiograms in 31 infants showed V (cm/s), V (cm/s), and E-wave IVPD (mmHg) at 1 week to be 66.2 ± 11.9, 75.3 ± 19.9, and 1.5 ± 0.4, respectively, while V, V, and E-wave IVPD at 1 month were 80.3 ± 14.4, 101.2 ± 28.3, and 2.42 ± 1.1, respectively. There were significant differences in V and segmental IVPD between first week and first month (p < 0.005) and IVPD between the age groups (p < 0.001).
Comprehensive analysis of transmitral color M-mode data is feasible in infants, enabling calculation of pressure drop between the LV base and apex and strength of propagation from two distinct slopes. Profound changes very early followed by relatively constant filling mechanics in later infancy indicate significant LV maturation occurring during the first month of life.
We implemented sophisticated analytic methods for color M-mode echocardiography in infants to assess age- and dimension-dependent changes in left ventricular diastolic function. Comprehensive characterization of transmitral color M-mode flow was feasible, enabling calculation of pressure drop between left ventricular base and apex and strength of propagation. Left ventricular diastolic filling function has predictable maturational progression, with significant differences in the intraventricular pressure between infants from birth to 2 years. This study forms the basis for future studies to examine alteration of early diastolic filling in congenital heart disease.
我们采用复杂的彩色 M 型分析方法来评估左心室（LV）舒张功能的年龄相关性进展。
前瞻性纳入正常婴儿，在 1 周、1 个月、6 个月、1 年和 2 年进行系列超声心动图检查。从彩色 M 型扫描中，在沿心尖至二尖瓣瓣扫描线的 3 个节段测量传播速度（V）、充盈强度（V）和室内压力差（IVPD）。
31 例婴儿的 121 次超声心动图检查显示，1 周时的舒张充盈的年龄相关性比较结果为 V（cm/s）、V（cm/s）和 E 波 IVPD（mmHg）分别为 66.2±11.9、75.3±19.9 和 1.5±0.4，而 1 个月时的 V、V 和 E 波 IVPD 分别为 80.3±14.4、101.2±28.3 和 2.42±1.1。第 1 周和第 1 个月之间 V 和节段 IVPD 差异显著（p<0.005），且不同年龄组之间 IVPD 差异显著（p<0.001）。
在婴儿中，进行全面的二尖瓣彩色 M 型数据分析是可行的，可计算 LV 基底与心尖之间的压力降和从两个不同斜率的传播强度。出生后第一个月内发生的深刻变化，随后是相对恒定的充盈力学，表明 LV 在生命的第一个月内发生了显著的成熟。
我们在婴儿中实施了复杂的彩色 M 型超声心动图分析方法，以评估左心室舒张功能的年龄和尺寸依赖性变化。全面描述二尖瓣彩色 M 型血流是可行的，可计算左心室基底与心尖之间的压力降和传播强度。左心室舒张充盈功能具有可预测的成熟进展，出生至 2 岁婴儿之间的室内压力差异显著。这项研究为未来研究探讨先天性心脏病早期舒张充盈的改变奠定了基础。
