Department of Neonatology, The Rotunda Hospital, Dublin, Ireland.
Department of Neonatology, The Rotunda Hospital, Dublin, Ireland.
J Pediatr. 2022 Jun;245:172-178.e5. doi: 10.1016/j.jpeds.2022.02.014. Epub 2022 Feb 14.
To assess the influence of diastolic dysfunction on the evolution of pulmonary hypertension in neonates with Down Syndrome over the early newborn period.
This was a prospective observational cohort study. Echocardiography was performed three times over the first week of life in both Down syndrome and control cohorts. Measurements of pulmonary arterial pressure in addition to left ventricular (LV) and right ventricular systolic and diastolic function were collected.
Seventy babies with Down syndrome and 60 control infants were enrolled. Forty-eight of the infants with Down syndrome (69%) were born with congenital heart disease (CHD). Echocardiography surrogates of pulmonary hypertension and myocardial function remained significantly impaired in the Down syndrome group in comparison with control infants (all P < .01). In the Down syndrome group, LV early diastolic strain rate was independently associated with measures of pulmonary hypertension while controlling for gestational age, cesarean delivery, and the presence of CHD (P < .01).
Intrinsic LV diastolic impairment is directly associated with higher indices of pulmonary hypertension in infants with Down syndrome and may be a contributing factor to its evolution.
评估舒张功能障碍对唐氏综合征新生儿在新生儿早期肺动脉高压演变的影响。
这是一项前瞻性观察性队列研究。在唐氏综合征和对照组中，在生命的第一周内进行了三次超声心动图检查。收集了肺动脉压以及左心室（LV）和右心室收缩和舒张功能的测量值。
共纳入 70 名唐氏综合征婴儿和 60 名对照婴儿。48 名唐氏综合征婴儿（69%）出生时患有先天性心脏病（CHD）。与对照组婴儿相比，唐氏综合征组的超声心动图替代肺动脉高压和心肌功能仍明显受损（均 P<.01）。在唐氏综合征组中，左心室早期舒张应变率与肺动脉高压的测量值独立相关，同时控制了胎龄、剖宫产和 CHD 的存在（P<.01）。
唐氏综合征婴儿的固有 LV 舒张功能障碍与更高的肺动脉高压指数直接相关，可能是其演变的一个促成因素。
