Lu Dan-Fang, Tong Xiao-Mei, Liu Yun-Feng, Zhang Hua
Department of Pediatrics, Peking University Third Hospital, Beijing, China.
Department of Epidemiology Center, Peking University Third Hospital, Beijing, China.
Front Pediatr. 2022 Jun 30;10:894152. doi: 10.3389/fped.2022.894152. eCollection 2022.
Few studies have examined the reference value of the left ventricular structure and function in preterm infants. This study was designed to establish a point-of-care echocardiographic reference range of left ventricular structure and function based on different gestational age, weight, and body surface area (BSA) for preterm infants within 7 days after birth.
We retrospectively studied 489 patients with traditional echocardiographic data of left ventricular (LV) M-mode: LV end diastolic dimensions (LVED), LV end systolic dimension (LVES), end-diastolic interventricular septal thickness (IVSd), end diastolic LV posterior wall thickness (LVPWd), left atrial (LA) and aortic root (AO) diameters, and index of LA/AO, LV ejection fraction (LVEF), LV fractional shortening (LVFS), and pulsed wave Doppler: aortic valve flow rate (AV), peak mitral valve flow rate E(MV-E), peak mitral valve flow rate A(MV-A), and MV-E/A. The LV dimensions and the maximum blood flow velocities of the aortic valves and mitral valves according to gestational age, birth weight, and body surface area (BSA) are presented in percentiles tables. Percentile curves of aforesaid four cardiac measurements (LVED, LA diameter (LAD), MV-E, MV-E/A) using the R language Generalized Additive Models for Location, Scale and Shape (GAMLSS) method were developed according to different gestational ages and weights.
Measurements of all cardiac dimensions and Doppler maximum velocities of AV, MV-E, and MV-E/A showed a correlation with gestational age, weight, and BSA. LVED, LAD, MV-E, and MV-E/A showed a trend of increasing values with gestational age and weight on the percentile curves.
The percentile tables and graphs of these point-of-care echocardiographic data can provide reliable reference data for Chinese neonates. Normative values are recommended as a source of reference data for the identification of potentially abnormal echocardiography.
很少有研究探讨早产儿左心室结构和功能的参考值。本研究旨在建立出生后7天内早产儿基于不同胎龄、体重和体表面积（BSA）的床旁超声心动图左心室结构和功能参考范围。
我们回顾性研究了489例有左心室（LV）M型传统超声心动图数据的患者：左心室舒张末期内径（LVED）、左心室收缩末期内径（LVES）、舒张末期室间隔厚度（IVSd）、舒张末期左心室后壁厚度（LVPWd）、左心房（LA）和主动脉根部（AO）直径以及LA/AO指数、左心室射血分数（LVEF）、左心室缩短分数（LVFS），以及脉冲波多普勒：主动脉瓣流速（AV）、二尖瓣峰值流速E（MV-E）、二尖瓣峰值流速A（MV-A）和MV-E/A。根据胎龄、出生体重和体表面积（BSA）列出左心室尺寸以及主动脉瓣和二尖瓣的最大血流速度的百分位数表。使用R语言的位置、尺度和形状广义相加模型（GAMLSS）方法，根据不同胎龄和体重绘制上述四项心脏测量指标（LVED、左心房直径（LAD）、MV-E、MV-E/A）的百分位数曲线。
所有心脏尺寸测量以及AV、MV-E和MV-E/A的多普勒最大速度均与胎龄、体重和BSA相关。LVED、LAD、MV-E和MV-E/A在百分位数曲线上显示出随胎龄和体重增加的趋势。
这些床旁超声心动图数据的百分位数表和图表可为中国新生儿提供可靠的参考数据。推荐将规范值作为识别潜在异常超声心动图的参考数据来源。
