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应用二维斑点追踪超声心动图分析晚发型小于胎龄儿及生长受限胎儿的心肌变形:一项前瞻性队列研究。

Myocardial deformation analysis in late-onset small-for-gestational-age and growth-restricted fetuses using two-dimensional speckle tracking echocardiography: a prospective cohort study.

机构信息

Department of Obstetrics and Gynecology, Technical University of Munich, School of Medicine, University Hospital rechts der Isar, Munich, Germany.

Statistics and Epidemiology, Technical University of Munich, School of Medicine, University Hospital rechts der Isar, Institute of Medical Informatics, Munich, Germany.

出版信息

J Perinat Med. 2021 Sep 17;50(3):305-312. doi: 10.1515/jpm-2021-0162. Print 2022 Mar 28.

Abstract

OBJECTIVES

An association between fetal growth restriction (FGR) and increased predisposition to cardiovascular disease (CVD) is suggested. The aim of this study was to evaluate subclinical signs of fetal cardiac remodeling in late-onset small-for-gestational-age (SGA) and growth-restricted fetuses using two-dimensional speckle tracking echocardiography (2D-STE).

METHODS

This is a prospective cohort study, including 117 late-onset (≥32 weeks) SGA (birthweight≤10th centile) fetuses and 102 gestational age matched controls. A subgroup analysis was performed: FGR was defined based on either BW (<third centile) or the presence of feto-maternal Doppler abnormalities, the remaining cases were called SGA centile 3-10. 2D-STE based myocardial deformation analyses included longitudinal peak systolic strain (LPSS) and strain rate (LSR) of the global left (LV) or right (RV) ventricle and its individual segments.

RESULTS

Global and segmental LPSS and LSR values showed no significant difference between late-onset SGA and control fetuses for both ventricles (p>0.05). Regarding global and segmental LPSS and LSR values of LV/RV, subgroup analysis revealed no significant difference between the FGR (n=81), SGA centile 3-10 (n=36) and control group.

CONCLUSIONS

A mild degree of placental dysfunction seems not to influence myocardial deformation properties measured by 2D-STE.

摘要

目的

有研究表明胎儿生长受限(FGR)与心血管疾病(CVD)易感性增加之间存在关联。本研究旨在通过二维斑点追踪超声心动图(2D-STE)评估晚期小于胎龄儿(SGA)和生长受限胎儿的胎儿心脏重构的亚临床迹象。

方法

这是一项前瞻性队列研究,纳入了 117 例晚期(≥32 周)SGA(出生体重≤第 10 百分位数)胎儿和 102 例胎龄匹配的对照组。进行了亚组分析:根据 BW(<第 3 百分位数)或存在胎儿-母体多普勒异常定义 FGR,其余病例称为 SGA 第 3-10 百分位数。2D-STE 基于心肌变形分析包括整体左心室(LV)或右心室(RV)的纵向收缩期峰值应变(LPSS)和应变率(LSR)及其各个节段。

结果

对于两个心室,晚期 SGA 与对照组胎儿的整体和节段 LPSS 和 LSR 值无显著差异(p>0.05)。对于 LV/RV 的整体和节段 LPSS 和 LSR 值,亚组分析显示 FGR(n=81)、SGA 第 3-10 百分位数(n=36)和对照组之间无显著差异。

结论

轻度胎盘功能障碍似乎不会影响 2D-STE 测量的心肌变形特性。

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