Blixenkrone-Møller Elisabeth, Dannesbo Sofie, Dehn Anna Maria, Pihl Christian A, Sillesen Anne-Sophie, Vøgg R Ottilia B, Raja Anna Axelsson, Colan Steven, Mertens Luc, Vejlstrup Niels, Bundgaard Henning, Iversen Kasper
Department of Cardiology, Copenhagen University Hospital Herlev, Borgmester Ib Juuls Vej 1, 2730, Copenhagen, Denmark.
Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
Pediatr Cardiol. 2024 Jul 13. doi: 10.1007/s00246-024-03571-0.
The prevalence of interatrial communications in newborns, i.e., patent foramen ovale or atrial septal defect, was previously reported to be between 24 and 92%, but the area has been impeded by lack of a universal classification method. A recently published novel echocardiographic diagnostic algorithm for systematic classification of interatrial communications had inter-and intraobserver agreements superior to standard expert assessment. This study aimed to determine the prevalence of subtypes of interatrial communications on transthoracic echocardiography in newborns. Echocardiograms of newborns aged 0-30 days were prospectively collected in the population-based cohort study Copenhagen Baby Heart Study in 2017-2018 and analyzed according to the new diagnostic algorithm, classifying interatrial communications into three subtypes of patent foramen ovale and three subtypes of atrial septal defects. Echocardiograms from 15,801 newborns were analyzed; 3416 (21.6%) were excluded due to suboptimal image quality or severe structural heart disease (n = 3), leaving 12,385 newborns (aged 12 [interquartile range 8; 15] days, 48.2% female) included in the study. An interatrial communication was detected in 9766 (78.9%) newborns. According to the algorithm, 9029 (72.9%) had a patent foramen ovale, while 737 (6.0%) fulfilled criteria for an atrial septal defect, further divided into subtypes. An interatrial communication was seen on echocardiography in almost 80% of newborns aged 0-30 days. Patent foramen ovale was 12 times more frequent than atrial septal defects. The observed prevalence of atrial septal defects was higher than previously reported. Follow up studies could distinguish which interatrial communications require follow-up or intervention. ClinicalTrial.gov, NCT02753348, posted April 27, 2016, [ https://classic.clinicaltrials.gov/ct2/show/NCT02753348 ].
新生儿房间隔交通的患病率，即卵圆孔未闭或房间隔缺损，此前报道为24%至92%，但该领域因缺乏通用分类方法而受到阻碍。最近发表的一种用于房间隔交通系统分类的新型超声心动图诊断算法，其观察者间和观察者内一致性优于标准专家评估。本研究旨在确定经胸超声心动图检查中新生儿房间隔交通亚型的患病率。在2017 - 2018年基于人群的队列研究哥本哈根婴儿心脏研究中，前瞻性收集了0至30天龄新生儿的超声心动图，并根据新的诊断算法进行分析，将房间隔交通分为卵圆孔未闭的三种亚型和房间隔缺损的三种亚型。分析了15801例新生儿的超声心动图；3416例（21.6%）因图像质量欠佳或严重结构性心脏病（n = 3）被排除，剩余12385例新生儿（年龄12[四分位间距8；15]天，48.2%为女性）纳入研究。9766例（78.9%）新生儿检测到房间隔交通。根据该算法，9029例（72.9%）有卵圆孔未闭，而737例（6.0%）符合房间隔缺损标准，并进一步分为亚型。在0至30天龄的新生儿中，近80%的婴儿超声心动图显示有房间隔交通。卵圆孔未闭的发生率比房间隔缺损高12倍。观察到的房间隔缺损患病率高于先前报道。后续研究可以区分哪些房间隔交通需要随访或干预。ClinicalTrial.gov，NCT02753348，2016年4月27日发布，[https://classic.clinicaltrials.gov/ct2/show/NCT02753348]
