Right Heart Function of Fetuses and Infants with Large Ventricular Septal Defect: A Longitudinal Case–Control Study

详细信息    查看全文

• 作者：Jiao Chen ; Liang Xie ; Li Dai ; Li Yu ; Lijun Liu ; Yongbi Zhou…
• 关键词：Ventricular septal defect ; Right ventricular function ; Fetuses ; Infants
• 刊名：Pediatric Cardiology
• 出版年：2016
• 出版时间：December 2016
• 年：2016
• 卷：37
• 期：8
• 页码：1488-1497
• 全文大小：2,619 KB
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Cardiology
  Cardiac Surgery
  Vascular Surgery
  
• 出版者：Springer New York
• ISSN：1432-1971
• 卷排序：37

文摘

The objective of this study was to detect the effect of a large ventricular septal defect (VSD) on right ventricular function before and after birth. All consecutive children with large VSD who were born in our hospital between January 2013–February 2016 and followed up throughout early infancy, and who lacked malformations or chromosomal abnormalities, were identified by a retrospective review of the medical records and included in this retrospective longitudinal case–control study (n = 30). Thirty normal control cases with an equivalent gestational age and gender served as controls. Tricuspid annular plane systolic excursion (TAPSE), right ventricle (RV) Tei index, and tricuspid E/E_m were measured in the fetal, neonatal (day 1–28), and infant (day 29–70) periods. In all periods, the VSD and control groups did not differ in TAPSE values, but VSD associated with higher Tei indices and tricuspid E/E_m values (in the fetal period: VSD group RV Tei was 0.48 ± 0.12 and E/E_m was 11.84 ± 1.53, control group RV Tei was 0.42 ± 0.16 and E/E_m was 10.16 ± 1.61; in neonatal period: VSD group RV Tei was 0.41 ± 0.17 and E/E_m was 12.21 ± 1.59, control group RV Tei was 0.30 ± 0.13 and E/E_m was 7.20 ± 1.28; in the infant period: VSD group RV Tei was 0.39 ± 0.09 and E/E_m was 11.89 ± 2.80, control group RV Tei was 0.28 ± 0.12 and E/E_m was 5.26 ± 1.90, all p < 0.05). In the fetal and neonatal periods, TAPSE correlated negatively with Tei index and tricuspid E/E_m in both groups. However, in the infant period, only the control group exhibited correlations between TAPSE and Tei index or tricuspid E/E_m. Tei index correlated positively with tricuspid E/E_m in both groups in all three periods. The VSD group had smaller correlation coefficients than the control group. Large VSD may already start to impair RV diastolic and global function before birth. This impairment continued and increased after birth. These changes did not associate with obvious RV longitudinal systolic function impairment. Large VSD mainly affected RV function by decreasing diastolic function and myocardial performance.