Chen Huiyun, Li Xiaoyu, Sun Fangcan, Zhang Jingjing, Liu Weizeyu, Dong Xinran, Li Hong, Xu Qiuqin, Han Bing
The First Affiliated Hospital of Soochow University, No. 899 Pinghai Street, Suzhou, Jiangsu, China.
Children's Hospital of Soochow University, No.92 Zhongnan Street, Suzhou, Jiangsu, China.
Arch Gynecol Obstet. 2025 Sep 8. doi: 10.1007/s00404-025-08088-2.
The study utilized non-invasive myocardial work indices to investigate myocardial injury in infants born to mothers with severe preeclampsia (SPE) and to explore the duration of this myocardial damage during the neonatal period.
This prospective study included 34 preterm infants born to mothers with SPE and 28 preterm infants born to mothers without severe pregnancy complications (termed "controls"). Echocardiography was performed in infants within 24 h of birth, then again at 48-72 h and 14-28 days, to obtain echocardiographic parameters. Two-dimensional speckle-tracking echocardiography (2D STE) was performed to construct a non-invasive left ventricular pressure-strain loop based on two-dimensional myocardial strain and non-invasive left ventricular systolic pressure measurements, allowing for the calculation of myocardial work indices.
Within 24 h after delivery, left ventricular stroke volume (SV), cardiac output (CO), and left ventricular global work index (GWI) in newborns born of mothers with SPE were significantly reduced compared to controls, while mitral E/e' and left ventricular longitudinal strain were increased. At 48-72 h after birth, mitral E/e' and left ventricular global waste work (GWW) increased, and global work efficiency (GWE) was reduced in infants of mothers with SPE. During the 14-28 days of the neonatal period, left ventricular SV and CO were reduced in the offspring of mothers with SPE and mitral E peak velocity, and E/e' and left ventricular GWW were increased.
The adverse intrauterine environment caused by SPE can lead to persistent impaired left ventricular function in preterm infants during the neonatal period.
本研究利用无创心肌工作指数来调查重度子痫前期（SPE）母亲所生婴儿的心肌损伤情况，并探讨新生儿期这种心肌损伤的持续时间。
这项前瞻性研究纳入了34名由患有SPE的母亲所生的早产儿以及28名由无严重妊娠并发症的母亲所生的早产儿（称为“对照组”）。在婴儿出生后24小时内进行超声心动图检查，然后在48 - 72小时和14 - 28天时再次进行检查，以获取超声心动图参数。采用二维斑点追踪超声心动图（2D STE），基于二维心肌应变和无创左心室收缩压测量构建无创左心室压力 - 应变环，从而计算心肌工作指数。
分娩后24小时内，与对照组相比，SPE母亲所生新生儿的左心室每搏输出量（SV）、心输出量（CO）和左心室整体工作指数（GWI）显著降低，而二尖瓣E/e'和左心室纵向应变增加。出生后48 - 72小时，SPE母亲所生婴儿的二尖瓣E/e'和左心室整体无用功（GWW）增加，整体工作效率（GWE）降低。在新生儿期的14 - 28天，SPE母亲所生后代的左心室SV和CO降低，二尖瓣E峰值速度、E/e'和左心室GWW增加。
SPE所导致的不良宫内环境可导致早产儿在新生儿期出现持续性左心室功能受损。
