在低可塑性左心综合征中围产期心脏功能适应:纵向分析
Olga Patey1, Lisa K Hornberger2, Angela McBrien1
1Fetal and Neonatal Cardiology Program, Echocardiography Laboratory, Division of Cardiology, Department of Pediatrics, Women and Children's Health Research, Mazankowski Alberta Heart Institute, and Cardiovascular Research Centre, University of Alberta, Edmonton, Alberta, Canada.
概括
患有低可塑性左心综合征 (HLHS) 的新生儿在围产期过渡期间显示出右心室 (RV) 几何和功能的改变. 这些变化适应出生后增加的RV负载和肺动脉需求.
科学领域:
- 心脏病学 心脏病学
- 新生儿生理学 新生儿生理学
- 遗传性心脏病研究 遗传性心脏病研究
背景情况:
- 围产期过渡涉及到显著的心脏负荷的变化.
- 与正常新生儿相比,患有低可塑性左心综合征 (HLHS) 的新生儿表现出较大的右心室 (RV) 输出.
- 了解HLHS中心脏适应机制至关重要.
研究的目的:
- 在围产过渡期间研究HLHS中心脏适应的机制.
- 为了比较RV功能和胎儿和新生儿的几何与HLHS与健康对照.
主要方法:
- 连续回声心脏成像 (传统,多普勒组织,斑点跟踪) 在35名高低血压妊娠和17名对照组中进行.
- 测量是在妊娠晚期和分娩后6,24和48小时进行的.
- 用各种心声学参数评估心脏功能.
主要成果:
- HLHS胎儿通过更高的中风体积,通过改变的RV几何形状 (球形,扩张) 和减少相对壁厚,具有与对照对象相比的RV输出.
- 在产后,HLHS新生儿由于心率增加和中风体积增加,显示RV心脏输出量升高.
- 在HLHS新生儿中观察到进一步的RV扩张,心肌变形变化和右心房扩大.
结论:
- 患有HLHS的孕期胎儿存在异常的RV几何形状和缩和放缩功能受损.
- 在HLHS中产后心脏变化似乎是对增加RV负载和肺流量需求的适应性反应.
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