Heitz F, Fouron J C, van Doesburg N H, Bard H, Teasdale F, Chessex P, Davignon A
Pediatrics. 1984 Dec;74(6):1069-74.
M-mode echocardiographic features suggesting a patent ductus arteriosus are based on two groups of indirect criteria: dilation of the left cardiac cavities and changes of systolic time intervals. The reliability of the first group of criteria has been questioned in fluid-limited, mechanically ventilated preterm infants. The sensitivity of the systolic time intervals in the same circumstances is investigated. Twenty-three patients with a large patent ductus arteriosus were selected. Review of their echocardiograms shows that the sensitivity of the various criteria (expressed as percentage of positivity) was as follows: inversion of the ratio of left ventricular preejection period to right ventricular preejection period, 91.3%; left ventricular preejection period to left ventricular ejection time over right ventricular preejection period to right ventricular ejection time less than 1,83%; left atrium dilation, 74%; shortening of left ventricular preejection period, 70%; dilation of left ventricular internal dimensions in diastole, 65%; increase in left atrium/aorta, 52%; and decrease of left ventricular preejection period to left ventricular ejection time, 48%. Three criteria involving time intervals (left ventricular preejection period to right ventricular preejection period, left ventricular preejection period, and left ventricular preejection period to left ventricular ejection time) had 100% specificity. The lowest specificity was found with criteria involving the left atrium (left atrial to aortic root ratio 75% and left atrium 63%). It is concluded that study of systolic time intervals is a reliable means of detecting preterm infants with hemodynamically significant left-to-right shunt through a patent ductus arteriosus even if the infants are mechanically ventilated and fluid restricted.
M型超声心动图提示动脉导管未闭的特征基于两组间接标准：左心腔扩张和收缩期时间间期改变。在液体限制、机械通气的早产儿中，第一组标准的可靠性受到质疑。本研究调查了相同情况下收缩期时间间期的敏感性。选取23例患有大型动脉导管未闭的患者。回顾他们的超声心动图显示，各种标准的敏感性（以阳性百分比表示）如下：左心室射血前期与右心室射血前期比值倒置，91.3%；左心室射血前期与左心室射血时间之比超过右心室射血前期与右心室射血时间之比小于1，83%；左心房扩张，74%；左心室射血前期缩短，70%；舒张期左心室内径扩张，65%；左心房/主动脉比值增加，52%；左心室射血前期与左心室射血时间减少，48%。涉及时间间期的三个标准（左心室射血前期与右心室射血前期、左心室射血前期、左心室射血前期与左心室射血时间）特异性为100%。涉及左心房的标准（左心房与主动脉根部比值75%，左心房63%）特异性最低。结论是，即使婴儿接受机械通气且液体受限，研究收缩期时间间期仍是检测因动脉导管未闭导致有血流动力学意义的左向右分流的早产儿的可靠方法。
