正常早期新生儿组织多普勒成像心肌活动指数分析
|
摘要
目的:采用组织多普勒成像测量正常早期新生儿的左、右心室心肌活动指数(Tei指数),观察时龄、体重、心率及前负荷等因素对Tei指数的影响,并建立早期新生儿Tei指数的正常值范围。方法:筛选出足月分娩的正常早期新生儿91例,应用组织多普勒成像技术检测其左、右房室瓣环的运动频谱,测量等容收缩时间(isovolumic contraction time,ICT)、等容舒张时间(isovolumic relaxation time,IRT)、射血时间(ejection time,ET),计算Tei指数。结果 :正常早期新生儿左、右心室Tei指数分别为0.38±0.04、0.32±0.06,两者间差异有统计学意义(P<0.05),且左、右心室Tei指数不受时龄、体重、心率、前负荷等因素影响。结论:组织多普勒成像测量Tei指数是一种简单、可靠、无创的定量综合评价心脏收缩和舒张功能的方法。确立正常早期新生儿的Tei指数范围,可为未来研究各种病理状态下早期新生儿心功能异常提供可靠的常规对照。
Objectives: To construct a reference chart for Tei index of normal early newborns assessed by tissue Doppler imaging(TDI) and to analyze the influencing factors such as age, weight, heart rate and preload on Tei index.Methods: Ninety-one normal early newborns were enrolled. The motion spectrum of mitral and tricuspid annulus was observed using TDI on early newborns. The isovolumic contraction time(ICT), isovolumic relaxation time(IRT) and ejection time(ET) of the left ventricle(LV) and right ventricle(RV) were measured respectively and the Tei index was calculated using the formula(ICT+IRT)/ET. Results: The Tei index of LV and RV in early newborn was significantly different(0.38±0.04 vs 0.32±0.06, P<0.05). The Tei index was not affected by factors such as age, weight, heart rate and preload. Conclusions:Tissue Doppler imaging provides an easily obtainable, noninvasive and reproducible method to assess Tei index for quanti-tative evaluating the cardiac systolic and diastolic function. The reference chart for Tei index of the early newborns provides a reliable conventional reference for future research on neonatal cardiac function in various pathological cardiac anomalies.
Objectives: To construct a reference chart for Tei index of normal early newborns assessed by tissue Doppler imaging(TDI) and to analyze the influencing factors such as age, weight, heart rate and preload on Tei index.Methods: Ninety-one normal early newborns were enrolled. The motion spectrum of mitral and tricuspid annulus was observed using TDI on early newborns. The isovolumic contraction time(ICT), isovolumic relaxation time(IRT) and ejection time(ET) of the left ventricle(LV) and right ventricle(RV) were measured respectively and the Tei index was calculated using the formula(ICT+IRT)/ET. Results: The Tei index of LV and RV in early newborn was significantly different(0.38±0.04 vs 0.32±0.06, P<0.05). The Tei index was not affected by factors such as age, weight, heart rate and preload. Conclusions:Tissue Doppler imaging provides an easily obtainable, noninvasive and reproducible method to assess Tei index for quanti-tative evaluating the cardiac systolic and diastolic function. The reference chart for Tei index of the early newborns provides a reliable conventional reference for future research on neonatal cardiac function in various pathological cardiac anomalies.
引文
[1]洪昭毅.各年龄分期[M]//王慕逖.儿科学.5版.北京:人民卫生出版社,2001:3-4.
[2]任苓,叶军,陈卫华,等.联合DTI技术与Tei指数评价高血压心脏病心功能的研究[J].重庆医学,2012,41(32):3425-3428.
[3]Karaye KM.Relationship between Tei Index and left ventricular geometric patterns in a hypertensive population:a cross-sectional study[J].Cardiovasc Ultrasound,2011,9:21.
[4]杜佩,杜国庆,李海茹,等.组织多普勒对单纯先天性心脏病相关肺动脉高压的再评估[J].中华超声医学杂志,2014,23(8):645-650.
[5]Tei C.New non-invasive index for combined systolic and diastolic ventricular function[J].J Cardiol,1995,26(2):135-136.
[6]La Corte JC,Cabreriza SE,Rabkin DG,et al.Correlation of the Tei index with invasive measurements of ventricular function in a porcine model[J].J Am Soc Echocardiogr,2003,16(5):442-447.
[7]Sernich S,Carrasquero N,Lavie CJ,et al.Noninvasive assessment of the right and left ventricular function in neonates with congenital diaphragmatic hernia with persistent pulmonary hypertension before and after surgical repair[J].Ochsner J,2006,6(2):48-53.
[8]王乐,周英,李明霞.Tei指数评价缺氧新生儿左心室功能障碍的作用研究[J].中国当代儿科杂志,2011,13(2):111-114.
[9]Ghawi H,Gendi S,Mallula K,et al.Fetal left and right ventricle myocardial performance index:defining normal values for the second and third trimesters--single tertiary center experience[J].Pediatr Cardiol,2013,34(8):1808-1815.
[10]薛静,邓涛,张周龙,等.组织多普勒与脉冲多普勒法Tei指数评价冠心病左心功能的对比研究[J].中国医学影像学杂志,2010,18(4):315-317.
[11]Abdel-Hady HE,Matter MK,El-Arman MM.Myocardial dysfunction in neonatal sepsis:a tissue Doppler imaging study[J].Pediatr Crit Care Med,2012,13(3):318-323.
[12]Cui W,Roberson DA,Chen Z,et al.Systolic and diastolic time intervals measured from Doppler tissue imaging:normal values and Z-score tables,and effects of age,heart rate,and body surface area[J].J Am Soc Echocardiogr,2008,21(4):361-370.
[13]尤利益,黄佩佩,张翔,等.超声心动图技术对新生儿左心功能评估作用的分析[J].中国妇幼保健,2014,29(11):1769-1772.
[14]张玉奇,陈树宝,孙锟,等.Tei指数估测正常及先天性心脏病儿童右心功能的研究[J].中国医学影像技术,2003,19(12):1669-1670.
[2]任苓,叶军,陈卫华,等.联合DTI技术与Tei指数评价高血压心脏病心功能的研究[J].重庆医学,2012,41(32):3425-3428.
[3]Karaye KM.Relationship between Tei Index and left ventricular geometric patterns in a hypertensive population:a cross-sectional study[J].Cardiovasc Ultrasound,2011,9:21.
[4]杜佩,杜国庆,李海茹,等.组织多普勒对单纯先天性心脏病相关肺动脉高压的再评估[J].中华超声医学杂志,2014,23(8):645-650.
[5]Tei C.New non-invasive index for combined systolic and diastolic ventricular function[J].J Cardiol,1995,26(2):135-136.
[6]La Corte JC,Cabreriza SE,Rabkin DG,et al.Correlation of the Tei index with invasive measurements of ventricular function in a porcine model[J].J Am Soc Echocardiogr,2003,16(5):442-447.
[7]Sernich S,Carrasquero N,Lavie CJ,et al.Noninvasive assessment of the right and left ventricular function in neonates with congenital diaphragmatic hernia with persistent pulmonary hypertension before and after surgical repair[J].Ochsner J,2006,6(2):48-53.
[8]王乐,周英,李明霞.Tei指数评价缺氧新生儿左心室功能障碍的作用研究[J].中国当代儿科杂志,2011,13(2):111-114.
[9]Ghawi H,Gendi S,Mallula K,et al.Fetal left and right ventricle myocardial performance index:defining normal values for the second and third trimesters--single tertiary center experience[J].Pediatr Cardiol,2013,34(8):1808-1815.
[10]薛静,邓涛,张周龙,等.组织多普勒与脉冲多普勒法Tei指数评价冠心病左心功能的对比研究[J].中国医学影像学杂志,2010,18(4):315-317.
[11]Abdel-Hady HE,Matter MK,El-Arman MM.Myocardial dysfunction in neonatal sepsis:a tissue Doppler imaging study[J].Pediatr Crit Care Med,2012,13(3):318-323.
[12]Cui W,Roberson DA,Chen Z,et al.Systolic and diastolic time intervals measured from Doppler tissue imaging:normal values and Z-score tables,and effects of age,heart rate,and body surface area[J].J Am Soc Echocardiogr,2008,21(4):361-370.
[13]尤利益,黄佩佩,张翔,等.超声心动图技术对新生儿左心功能评估作用的分析[J].中国妇幼保健,2014,29(11):1769-1772.
[14]张玉奇,陈树宝,孙锟,等.Tei指数估测正常及先天性心脏病儿童右心功能的研究[J].中国医学影像技术,2003,19(12):1669-1670.