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在患有先天性隔膜的患者中,心室功能障碍在修复后死亡
Catherine M Avitabile1, Yan Wang2, Devon Ash2
1Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA; Division of Cardiology and Echocardiography Laboratory Research Unit, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.
Journal of pediatric surgery
|October 23, 2024
概括
在患有先天性隔膜 (CDH) 的新生儿中,左心室尺寸较小,预测了手术修复后的早期死亡率. 心声图可能有助于对这些危急患者的风险进行分层.
科学领域:
- 儿童心脏病学 儿童心脏病学
- 新生儿重症监护中心新生儿重症监护中心
- 遗传异常 是一种先天性异常.
背景情况:
- 在患有先天性隔膜 (CDH) 的儿科患者中,肺高血压 (PH) 与死亡率有关.
- 定量回声心脏图 (回声) 对于评估PH中的心室功能至关重要,但CDH幸存者的数据有限.
- 很少有研究报告CDH非幸存者的定量回声数据,超过生命的第一个星期.
研究的目的:
- 调查在住院期间死亡的新生儿CDH患者心室大小和功能的定量心声测量.
- 为了比较CDH患者手术修复后的早期 (<30天) 和晚期 (>30天) 死亡之间的回声结果.
主要方法:
- 在手术修复后在新生儿住院期间死亡的CDH患者 (2013-2022) 的回顾性,横截面队列研究.
- 右 (RV) 和左心室 (LV) 大小和功能的定量回声测量在死亡前的最后回声心脏图上线下分析.
- 早期和晚期死亡组之间的回声数据的统计比较 (Wilcoxon排名总和测试).
主要成果:
- 分析了25名已故的CDH患者 (11例早期死亡,14例晚期死亡).
- 早期死亡的患者与晚期死亡患者相比,LV终端-透析维度Z-分数显著较小.
- 趋势表明,早期死亡组的RV和LV功能恶化,包括TAPSEZ,RVFAC和菌株参数减少.
结论:
- 室腔缺血和功能障碍可能会影响CDH患者的死亡率.
- 定量心声回声学发现显示了CDH风险分层的潜力,需要进一步调查.
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