School of Mechanical Engineering, Purdue University, West Lafayette, IN, United States of America.
Department of Mechanical Engineering, University of Maryland, Baltimore County, Baltimore, MD, United States of America.
PLoS One. 2024 Sep 19;19(9):e0308645. doi: 10.1371/journal.pone.0308645. eCollection 2024.
The perinatal transition's impact on systemic right ventricle (SRV) cardiac hemodynamics is not fully understood. Standard clinical image analysis tools fall short of capturing comprehensive diastolic and systolic measures of these hemodynamics.
Compare standard and novel hemodynamic echocardiogram (echo) parameters to quantify perinatal changes in SRV and healthy controls.
We performed a retrospective study of 10 SRV patients with echocardiograms at 33-weeks gestation and at day of birth and 12 age-matched controls. We used in-house developed analysis algorithms to quantify ventricular biomechanics from four-chamber B-mode and color Doppler scans. Cardiac morphology, hemodynamics, tissue motion, deformation, and flow parameters were measured.
Tissue motion, deformation, and index measurements did not reliably capture biomechanical changes. Stroke volume and cardiac output were nearly twice as large for the SRV compared to the control RV and left ventricle (LV) due to RV enlargement. The enlarged RV exhibited disordered flow with higher energy loss (EL) compared to prenatal control LV and postnatal control RV and LV. Furthermore, the enlarged RV demonstrated elevated vortex strength (VS) and kinetic energy (KE) compared to both the control RV and LV, prenatally and postnatally. The SRV showed reduced relaxation with increased early filling velocity (E) compared prenatally to the LV and postnatally to the control RV and LV. Furthermore, increased recovery pressure (ΔP) was observed between the SRV and control RV and LV, prenatally and postnatally.
The novel hydrodynamic parameters more reliably capture the SRV alterations than traditional parameters.
围产期过渡对系统性右心室（SRV）心脏血液动力学的影响尚未完全了解。标准的临床影像分析工具无法全面捕捉这些血液动力学的舒张和收缩指标。
比较标准和新型血流动力超声心动图（echo）参数，以量化 SRV 和健康对照者的围产期变化。
我们对 10 名 SRV 患者进行了回顾性研究，这些患者在 33 周妊娠时、出生当天和 12 名年龄匹配的对照组进行了超声心动图检查。我们使用内部开发的分析算法从四腔心 B 模式和彩色多普勒扫描中量化心室生物力学。测量心脏形态、血液动力学、组织运动、变形和流动参数。
组织运动、变形和指数测量无法可靠地捕捉生物力学变化。由于 RV 增大，SRV 的每搏输出量和心输出量几乎是对照组 RV 和 LV 的两倍。与产前对照组 LV 和产后对照组 RV 和 LV 相比，增大的 RV 显示出紊乱的血流，能量损失（EL）更高。此外，与产前和产后对照组 RV 和 LV 相比，增大的 RV 显示出更高的涡旋强度（VS）和动能（KE）。SRV 显示出与 LV 相比，在产前和与对照组 RV 和 LV 相比，在产后的早期充盈速度（E）增加，舒张功能下降。此外，SRV 与对照组 RV 和 LV 之间在产前和产后观察到恢复压力（ΔP）增加。
与传统参数相比，新型流体动力学参数更可靠地捕捉到 SRV 的改变。
