在双胞胎对双胞胎输血综合征期间,心肌性能的早期结合差异
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
概括
双胞胎对双胞胎输血综合征 (TTTS) 可能会导致由于压力过载而导致心脏功能障碍. 早期评估双胞胎之间的心肌性能指数 (MPI) 差异可以帮助区分TTTS和子宫内生长限制 (IUGR).
科学领域:
- 心脏病学 心脏病学
- 胎儿医学 胎儿医学
- 周围生理学 周围生理学
背景情况:
- 双胞胎对双胞胎输血综合征 (TTTS) 越来越多地与压力过载有关,导致接受双胞胎心肌病.
- 心脏功能障碍可能是TTTS的早期指标.
- 区分TTTS和子宫内生长限制 (IUGR) 对于及时干预至关重要.
研究的目的:
- 在TTTS中调查心肌功能早期交织差异.
- 确定这些差异是否可以区分TTTS和IUGR.
主要方法:
- 对双胞胎进行胎儿心声扫描,对双胞胎进行了TTTS (n=21) 和IUGR (n=11).
- 分析了8个心声波变量,重点关注心脏尺寸和多普勒参数.
- 肌动脉性能指数 (MPI) 为两个心室计算.
主要成果:
- 在TTTS和IUGR组之间,心胸比率或带/脑动脉多普勒指数没有发现显著差异.
- 心室隔膜厚度有所不同,但与这两种情况都无关.
- 接受TTTS的双胞胎显示左心室缩短分数较高,MPI因长时间的异体积周期而升高,主要是在放松期间.
- 在LV和RV的MPI值的具体变化确定TTTS具有75%的灵敏度和9%的错误阳性率.
结论:
- 在TTTS中观察到的透缩功能障碍支持压力过载假设.
- 交织MPI评估是TTTS和IUGR之间的早期差异诊断的一个有价值的工具.
相关概念视频
Pathophysiology of Cardiac Performance
Typical heart performance is influenced by heart rate, rhythm, myocardial contraction, and metabolism or blood flow. The cardiac muscle exhibits distinct electrophysiological features, including pacemaker activity and calcium channel control, which play a vital role in the heart's response to various drugs. The autonomic nervous system, comprising the sympathetic and parasympathetic branches, regulates heart rate. Sympathetic activation increases heart rate, while parasympathetic activation...
Imbalances in Cardiac Output
The heart's primary function is to pump blood throughout the body, maintaining a balance between blood sent out (cardiac output) and blood returning (venous return). If this balance is disrupted, it can result in congestive heart failure (CHF), a severe condition where the heart becomes an inefficient pump, leading to inadequate blood circulation.
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send blood...
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send blood...
Development of the Heart
The development of the human heart, a crucial organ, commences from the mesoderm on the 18th or 19th day after fertilization. This process initiates in the cardiogenic area, a group of mesodermal cells at the embryo's head end, which evolves into elongated strands known as cardiogenic cords. These cords undergo a transformation to form hollow-centered endocardial tubes.
As the embryo undergoes lateral folding, these paired tubes approach each other, merging into a single primitive heart tube by...
As the embryo undergoes lateral folding, these paired tubes approach each other, merging into a single primitive heart tube by...
Development of Blood Vessels
The development of the vascular system in a fetus is a complex and intricate process that begins as early as 15 to 16 days post-conception. This process starts outside the embryo, specifically in the mesoderm of the yolk sac, chorion, and connecting stalk. Approximately two days later, the formation of blood vessels occurs within the embryo itself.
The initial formation of this system is facilitated by the small amount of yolk present in the ovum and yolk sac. Blood vessels originate from...
The initial formation of this system is facilitated by the small amount of yolk present in the ovum and yolk sac. Blood vessels originate from...
Fetal Circulation
Fetal circulation is a unique system that facilitates the exchange of gases, nutrients, and waste products between the developing fetus and the mother. This intricate process takes place through a special organ called the placenta.
Two umbilical arteries transport blood from the fetus to the placenta. At the placenta, the blood absorbs oxygen and nutrients while simultaneously eliminating waste products. This oxygen-enriched and nutrient-rich blood then returns to the fetus through one...
Two umbilical arteries transport blood from the fetus to the placenta. At the placenta, the blood absorbs oxygen and nutrients while simultaneously eliminating waste products. This oxygen-enriched and nutrient-rich blood then returns to the fetus through one...
Blood Studies for Cardiovascular System I: Cardiac Biomarkers
Cardiac biomarkers are enzymes, proteins, and hormones released into the blood when cardiac cells are injured. They are powerful tools for triaging.
The essential diagnostic tools for detecting myocardial necrosis and monitoring individuals suspected of having acute coronary syndrome (ACS) include:
Troponins
Troponins, particularly cardiac troponins I and T, are the most precise and sensitive markers of myocardial injury. They are detectable within 4-6 hours of myocardial injury and remain...
The essential diagnostic tools for detecting myocardial necrosis and monitoring individuals suspected of having acute coronary syndrome (ACS) include:
Troponins
Troponins, particularly cardiac troponins I and T, are the most precise and sensitive markers of myocardial injury. They are detectable within 4-6 hours of myocardial injury and remain...


