Department of Cardiovascular Technology, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India.
Department of Cardiology, Sahyadri Narayana Multi Speciality Hospital, Shivamogga, Karnataka, India.
J Matern Fetal Neonatal Med. 2024 Dec;37(1):2392783. doi: 10.1080/14767058.2024.2392783. Epub 2024 Aug 25.
To evaluate cardiac structural and functional changes in neonates with fetal growth restriction (FGR) compared to appropriate-for-gestational-age (AGA) neonates using conventional echocardiography, tissue Doppler imaging (TDI), and speckle tracking echocardiography.
This case-control study included 85 FGR neonates and 75 non-FGR, weight adequate for gestational age neonates. Among these, 37 were symmetric FGR and 48 were asymmetric FGR. All the biophysical profiles of these newborns were assessed. An echocardiographic test was performed to evaluate cardiac dimension, Left ventricular ejection fraction (LV EF), Mitral valve Doppler flow velocities, myocardial performance index, tissue annular velocities, and LV global longitudinal strain (GLS).
Although LVEF was found to be within the normal range, mean EF was reduced among neonates with FGR than non-FGR controls (EF: 66.14 ± 3.85% vs 69.46 ± 3.58%; < 0.001, in FGR and non-FGR, respectively). Furthermore, LV E/E' a measure of LV diastolic function was altered among both types of FGR neonates. Similarly, LV GLS was reduced among FGR neonates (LV GLS: -20.69 ± 2.7% vs -19.06 ± 2.9%; < 0.001 in non-FGR and FGR, respectively).
FGR neonates exhibit significant alterations in cardiac geometry compared to AGA controls. FGR neonates also demonstrated a significant reduction in LV EF, FS, and LV global longitudinal strain, depicting failure to adapt to the increased cardiac workload after birth.
使用常规超声心动图、组织多普勒成像（TDI）和斑点追踪超声心动图评估胎儿生长受限（FGR）新生儿与适于胎龄（AGA）新生儿的心脏结构和功能变化。
本病例对照研究纳入了 85 例 FGR 新生儿和 75 例非 FGR、胎龄适当的体重新生儿。其中，37 例为对称型 FGR，48 例为不对称型 FGR。对这些新生儿的所有生物物理特征进行评估。进行超声心动图检查以评估心脏尺寸、左心室射血分数（LV EF）、二尖瓣多普勒血流速度、心肌做功指数、组织环速度和左心室整体纵向应变（GLS）。
尽管 LVEF 处于正常范围内，但 FGR 新生儿的平均 EF 低于非 FGR 对照组（EF：66.14±3.85%比 69.46±3.58%； < 0.001，分别在 FGR 和非 FGR 中）。此外，LV E/E'（一种评估 LV 舒张功能的指标）在两种类型的 FGR 新生儿中均发生改变。同样，FGR 新生儿的 LV GLS 降低（LV GLS：-20.69±2.7%比-19.06±2.9%； < 0.001，分别在非 FGR 和 FGR 中）。
与 AGA 对照组相比，FGR 新生儿的心脏几何形状存在明显变化。FGR 新生儿的 LV EF、FS 和 LV 整体纵向应变也显著降低，表明出生后无法适应增加的心脏工作量。
