Department of Neonatology, Hospital Español de México, Mexico City, Mexico.
Postgraduate Department, School of Medicine Universidad La Salle México, Mexico City, Mexico.
Arch Cardiol Mex. 2021;91(3):315-320. doi: 10.24875/ACM.20000063.
Right ventricle (RV) function plays an important role during fetal and neonatal transitional circulation. Despite the published echocardiography guidelines in children including neonates, there is scare evidence on RV assessment using echocardiography in Mexican neonates. This study was aimed at assessing RV function and anatomical measures in healthy term newborns and defines normal values in this cohort of patients.
A prospective study involving healthy term newborns in a single center were enrolled in the study to assess RV, all patients were recruited within 24-72 h after birth. The right ventricular assessment was performed as per American Society of Echocardiography's guidelines.
Seventy healthy term newborns with a median gestational age of 38 (38.5 ± 2.7) weeks had RV function assessment and anatomical structures measures with a predefined ten echocardiographic parameters protocol. The mean values for: tricuspid valve diameter was 13 mm ± 1.8, basal diameter of the RV 16.7 mm ± 2, RV length 27.8 mm ± 2.2, mid cavity diameter 14.3 mm ± 1.7, RV-anteroinferior basal diameter 21.5 mm ± 2.5, tricuspid regurgitation gradient 13.3 mmHg ± 5.9, tricuspid annular plane systolic excursion 8.7 mm, right ventricular fractional area change (RVFAC) 4 chamber (%) 40.6 ± 7.5, tricuspid E/A 0.7 ± 0.5, myocardial velocities (cm/s) E´ 8 ± 2.7, A´ 9.6 ± 2.4, S´ 6.9 ± 1.2, myocardial performance index 0.5 ± 0.1, RVFAC 3 chamber (%) 37.8 ± 15.8, and pulmonary acceleration time mean value 58.8 ± 14.9. Flattening of interventricular septum was seen in 13% infants.
This study describes echocardiographic parameters for anatomical structures and assessment of RV function in healthy term newborns during transitional circulation. We reported novel anatomical measures of the RV; this information can provide normal reference range values and be referenced while assessing RV function in normal and sick newborns during transitional circulation.
右心室（RV）功能在胎儿和新生儿过渡期循环中起着重要作用。尽管已经发表了包括新生儿在内的儿科超声心动图指南，但在墨西哥新生儿中使用超声心动图评估 RV 的证据很少。本研究旨在评估健康足月新生儿的 RV 功能和解剖学指标，并确定该患者队列的正常数值。
在一家单中心，对 70 名健康足月新生儿进行前瞻性研究，以评估 RV。所有患者均在出生后 24-72 小时内入组。根据美国超声心动图学会的指南进行 RV 评估。
70 名健康足月新生儿，中位胎龄 38（38.5±2.7）周，进行了 RV 功能评估和解剖结构测量，采用了预先设定的十个超声心动图参数方案。平均：三尖瓣瓣环直径 13mm±1.8，右心室基底直径 16.7mm±2，RV 长度 27.8mm±2.2，中腔直径 14.3mm±1.7，RV-前下基底直径 21.5mm±2.5，三尖瓣反流梯度 13.3mmHg±5.9，三尖瓣环平面收缩期位移 8.7mm，右心室整体射血分数（RVFAC）四腔心 (%) 40.6±7.5，三尖瓣 E/A 0.7±0.5，心肌速度（cm/s）E´ 8±2.7，A´ 9.6±2.4，S´ 6.9±1.2，心肌做功指数 0.5±0.1，RVFAC 三腔心 (%) 37.8±15.8，肺动脉加速时间平均值 58.8±14.9。13%的婴儿出现室间隔平坦。
本研究描述了过渡循环中健康足月新生儿 RV 功能和解剖结构的超声心动图参数。我们报告了 RV 的新解剖学指标；这些信息可以提供正常参考范围值，并在过渡循环中评估正常和患病新生儿的 RV 功能时参考。
