胎内膜内气管封闭 (FETO) 后患有严重先天性隔膜的婴儿的心声学变化
Catherine M Avitabile1,2, Sabrina Flohr3, Leny Mathew3
1Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA. avitabilec@chop.edu.
Pediatric cardiology
|December 13, 2024
概括
在先天性隔膜 (CDH) 患者的胎盘内膜气管封闭 (FETO) 显示出右心室功能改善和较少的左心室缺血. FETO影响心脏大小和功能,在修复后具有更好的RV静脉缩功能.
科学领域:
- 心脏病学 心脏病学
- 儿科手术 儿科手术
- 新生儿科学 新生儿科学
背景情况:
- kongenital diaphragmatic hernia (CDH) 带来了严重的生存挑战. 这是一个非常严重的疾病.
- 胎镜内膜气管封闭 (FETO) 是一种有前途的干预措施,以促进CDH中的肺生长.
- FETO对产后心脏结构和功能的影响在很大程度上仍未被描述.
研究的目的:
- 评估FETO对CDH患者右心室 (RV) 和左心室 (LV) 大小和功能的影响.
- 为了比较FETO治疗和控制CDH患者之间的心脏参数.
- 为了评估FETO和CDH修复后随着时间的推移心脏功能的变化.
主要方法:
- 追溯队列研究比较了10名FETO患者和22名控制CDH患者.
- 分析了包括TAPSEZ,RVFAC,RVGLS,RVFWS,RV/LV比率,LVEI和LV透静/收缩Z-score在内的定量心声测量.
- 使用非参数测试和线性回归模型来比较群体并评估随时间变化的变化.
主要成果:
- FETO患者最初呈现较小的RV/LV比率和较低的LVEI,表明较少的RV扩张和隔膜位移.
- 在FETO患者中,在第一个心声回声图上,LV低血积的严重程度较小.
- 在修复后,FETO患者与对照人群相比显著改善了RV缩功能 (RVFAC,RVGLS,RVFWS).
结论:
- 在CDH患者中,FETO影响产后心脏形态和功能.
- FETO与减少RV扩张和LV低成形有关.
- 在FETO治疗的CDH幸存者中观察到改善的RV缩功能.
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