双生児対双生児輸血症候群における心筋機能における早期の双生児間の差異
M J Raboisson1, J C Fouron, J Lamoureux
1Fetal Cardiology Unit, Cardiology Division, Department of Pediatrics, St. Justine Hospital, Université de Montréal, Montreal, Quebec, Canada.
Circulation
|November 3, 2004
まとめ
双子対双子輸血症候群 (TTTS) は,圧力過負荷による心臓機能不全を引き起こす可能性があります. 双子間の心筋機能指数 (MPI) 差異の早期評価は,子宮内成長制限 (IUGR) からTTTSを区別するのに役立ちます.
科学分野:
- 心臓病学 心臓病学
- 胎児医学 胎児医学について
- ペリナトロジー (Perinatology) とは
背景:
- 双子対双子輸血症候群 (TTTS) は,受給者の双子の心筋不全を引き起こす圧力過負荷とますます関連しています.
- 心臓機能不全は,TTTSの初期指標である可能性があります.
- TTTSと子宮内成長制限 (IUGR) を区別することは,適切な介入に不可欠です.
研究 の 目的:
- TTTSにおける心筋機能の早期の相互作用差異を調査する.
- これらの違いが,TTTSとIUGRを区別できるかどうかを判断する.
主な方法:
- 胎児エコーカルディオグラフィは,TTTS (n=21) とIUGR (n=11) を有する双子に実施した.
- 8つのエコーカルディオグラフィック変数を分析し,心臓の寸法とドップラーパラメータに焦点を当てました.
- 筋のパフォーマンス指数 (MPI) は,両心室で計算されました.
主要な成果:
- TTTSとIUGRのグループ間の心胸比率や帯/脳動脈ドップラー指数において,有意な差異は認められなかった.
- 静脈隔膜の厚さは異なっていたが,どちらの状態とも関連していなかった.
- TTTSで受診した双子は,主にリラックス中に,長時間のイソヴォルミック期間のために,左心房の縮小分子が高く,MPIが上昇した.
- LVとRVのMPI値の特定の変化により,TTTSは75%の感度と9%の偽陽性率で特定されました.
結論:
- TTTSで観察されたダイアストリック機能不全は,圧力過負荷仮説を支持する.
- 絡み合ったMPI評価は,TTTSとIUGRの早期の差異診断のための貴重なツールです.
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