Roguin N, Du Z D, Barak M, Nasser N, Hershkowitz S, Milgram E
Heart Institute and Department of Neonatology, Western Galilee Hospital-Nahariya, Technion Faculty of Medicine, Israel.
J Am Coll Cardiol. 1995 Nov 15;26(6):1545-8. doi: 10.1016/0735-1097(95)00358-4.
This study sought to use echocardiography to evaluate the prevalence of muscular ventricular septal defect in neonates.
Ventricular septal defect is usually asymptomatic and closes spontaneously. An increase in its prevalence has been noted recently. One reason is the improved detection of small defects, especially with the increased used of echocardiography. Therefore, one would expect a higher prevalence in neonates on the basis of echocardiographic screening.
Color Doppler echocardiography was performed in 1,053 consecutive neonates 6 to 170 h old at Western Galilee Hospital, Israel. Data on the neonates, parents and family were obtained to analyze the influencing factors. The identified patients were followed up for 1 to 10 months or until ventricular septal defect closure.
Muscular ventricular septal defect was found in 56 (25 male, 31 female) of the 1,053 neonates, a prevalence of 53.2/1,000 live births. All neonates were asymptomatic. Six had a systolic murmur. Electrocardiographic findings were normal in 44 (97.8%) of 45 neonates followed up, and left ventricular hypertrophy occurred in 1 (2.2%). By echocardiography, 50 ventricular septal defects (89.3%) were single and 6 (10.7%) were multiple. The defects (range 1 to 5 mm in diameter, mean [+/- SD] 2.3 +/- 0.8) occurred anywhere along the muscular septum; 43 (76.8%) were detectable only on color Doppler imaging. The left atrium and left ventricle were mildly dilated. Of 45 neonates who were followed up for 6 to 10 months or until closure of the defects, 40 (88.9%) had defects that closed spontaneously. The risk of ventricular septal defect was not significantly associated with gestational age, birth weight, birth order, maternal age, diabetes, smoking, exposure to drugs or infection, paternal age, familial congenital heart disease, religion or consanguinity.
There is a prevalence of muscular ventricular septal defect in neonates of 53.2/1,000 live births. The patients were asymptomatic, and 88.9% had defects that closed spontaneously within 1 to 10 months. These defects may be caused by environmental factors. In many cases, muscular ventricular septal defect may also result from delayed physiologic development.
本研究旨在利用超声心动图评估新生儿肌部室间隔缺损的患病率。
室间隔缺损通常无症状且可自发闭合。最近其患病率有所上升。原因之一是对小缺损的检测有所改善，尤其是随着超声心动图使用的增加。因此，基于超声心动图筛查，预计新生儿中的患病率会更高。
对以色列加利利西部医院1053例年龄在6至170小时的连续新生儿进行彩色多普勒超声心动图检查。获取有关新生儿、父母和家庭的数据以分析影响因素。对确诊患者进行1至10个月的随访或直至室间隔缺损闭合。
1053例新生儿中有56例（男25例，女31例）发现肌部室间隔缺损，活产儿患病率为53.2/1000。所有新生儿均无症状。6例有收缩期杂音。45例接受随访的新生儿中，44例（97.8%）心电图结果正常，1例（2.2%）出现左心室肥厚。通过超声心动图检查，50例室间隔缺损（89.3%）为单发，6例（10.7%）为多发。缺损直径范围为1至5毫米，平均（±标准差）为2.3±0.8毫米，出现在肌性间隔的任何部位；43例（76.8%）仅在彩色多普勒成像时可检测到。左心房和左心室轻度扩张。45例随访6至10个月或直至缺损闭合的新生儿中，40例（88.9%）的缺损自发闭合。室间隔缺损的风险与胎龄、出生体重、产次、母亲年龄、糖尿病、吸烟、药物或感染暴露、父亲年龄、家族性先天性心脏病、宗教或近亲结婚无显著关联。
新生儿肌部室间隔缺损的患病率为53.2/1000活产儿。患者无症状，88.9%的患者在1至10个月内缺损自发闭合。这些缺损可能由环境因素引起。在许多情况下，肌部室间隔缺损也可能是生理性发育延迟所致。
