组织多普勒纵向评估正常胎儿及新生儿Tei指数
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摘要
目的采用组织多普勒成像(TDI)纵向评估正常中晚孕同一胎儿不同孕周及新生儿期左、右室Tei指数的范围,并探讨Tei指数与孕周的关系。方法应用TDI测量100例同一正常孕妇的正常胎儿在不同孕周(22~24周、32~34周、36~38周)及新生儿期二、三尖瓣环的运动频谱,测量等容收缩时间(ICT)、等容舒张时间(IRT)、射血时间(ET),计算Tei指数,将同一胎儿不同孕周及新生儿期左、右心室Tei指数进行统计分析。结果正常胎儿不同孕周(22~24周、32~34周、36~38周)及新生儿期左、右心室Tei指数分别为0.452±0.054、0.452±0.057、0.418±0.065、0.368±0.061,0.453±0.045,0.453±0.054、0.399±0.056、0.316±0.069;左、右心室Tei指数不同时期间差别有统计学意义(P<0.05),34周前Tei指数随孕周增加无变化,34周后随孕周增加而下降,新生儿期进一步降低。结论 TDI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,同一正常孕妇的正常胎儿在不同孕周及新生儿期Tei指数测量值范围为未来研究各种病理状态下的胎儿、新生儿心功能异常提供可靠的常规对照指标。
Objective The aim of this study was to construct reference charts for Tei index in middle-late pregnancy normal fetuses and newborns,longitudinal assessed by Tissue Doppler imaging(TDI)and to analyze the influence of gestational age on Tei index.Methods The study group consisted of 100 normal fetuses and newborns.The motion of mitral and tricuspid annuli was observed using TDI on different gestational ages and newborn of every fetus.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 calculated using the formula(ICT+IRT)/ET.Results The Tei indices of LV and RV were significantly different among different periods respectively(0.452±0.054,0.452±0.057,0.418±0.065,0.368±0.061,0.453±0.045,0.453±0.054,0.399±0.056,0.316±0.069,both P<0.05).From 22 to 34weeks of gestation,the Tei index of both left and right ventricles remained unchanged,declined with the increase of gestational age after 34 weeks of gestation,and further reduced in the newborn period.Conclusions TDI provides an easily obtainable,noninvasive and reproducible method to assess Tei index in quantitative evaluating of cardiac systolic and diastolic function.The reference charts for Tei index of the same normal pregnant women of normal fetus in different gestational ages and the neonatal period provide reliable conventional control indicators for future research on various pathological conditions of fetal and neonatal cardiac function anomalies.
Objective The aim of this study was to construct reference charts for Tei index in middle-late pregnancy normal fetuses and newborns,longitudinal assessed by Tissue Doppler imaging(TDI)and to analyze the influence of gestational age on Tei index.Methods The study group consisted of 100 normal fetuses and newborns.The motion of mitral and tricuspid annuli was observed using TDI on different gestational ages and newborn of every fetus.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 calculated using the formula(ICT+IRT)/ET.Results The Tei indices of LV and RV were significantly different among different periods respectively(0.452±0.054,0.452±0.057,0.418±0.065,0.368±0.061,0.453±0.045,0.453±0.054,0.399±0.056,0.316±0.069,both P<0.05).From 22 to 34weeks of gestation,the Tei index of both left and right ventricles remained unchanged,declined with the increase of gestational age after 34 weeks of gestation,and further reduced in the newborn period.Conclusions TDI provides an easily obtainable,noninvasive and reproducible method to assess Tei index in quantitative evaluating of cardiac systolic and diastolic function.The reference charts for Tei index of the same normal pregnant women of normal fetus in different gestational ages and the neonatal period provide reliable conventional control indicators for future research on various pathological conditions of fetal and neonatal cardiac function anomalies.
引文
[1]于蕾,任卫东,李玉宏,等.Tei指数评价原发性高血压患者左室收缩及舒张功能的临床研究.中国超声医学杂志,2005,21(7):506-508.
[2]Vonk MC,Sander MH,van den Hoogen FH,et al.Right ventricle Tei-index:a tool to increase the accuracy of non-invasive detection of pulmonary arterial hypertension in connective tissue diseases.Eur J Echocardiogr,2007,8(5):317-321.
[3]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.中华超声医学杂志,2014,23(8):645-650.
[4]Tei C.New noninvasive index for combined systolic and diastolic ventricular function.J Cardial,1995,26(2):135-136.
[5]王琨,谢红宁,李丽娟,等.应用Tei指数评价正常和宫内缺氧胎儿心功能.中华生物医学工程杂志,2014,20(3):191-194.
[6]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.Pediatr Cardiol,2013,34(8):1808-1815.
[7]Friedman D,Buyon J,Kim M,et a1.Fetal cardiac function assessed by DoppIer myocardial performance index(Tei index).UItrasound Obstet Gynecol,2003,21(1):33-36.
[8]Tsutsumi T,Ishii M,Eto G,et al.Serial evaluation for myocardial performance in fetuses and neonates using a new Doppler index.Pediatr Int,1999,41(6):722-727.
[9]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.中国医学影像学杂志,2010,18(4):315-317.
[10]Matter M,Abdel-Hady H,Attia G,et al.Myocardial performance in asphyxiated full-term infants assessed by Doppler tissue imaging.Pediatr Cardiol,2010,31(5):634-642.
[11]章鸣,周启昌,彭清海,等.组织多普勒成像评价正常胎儿左、右室Tei指数的研究.中国超声医学杂志,2005,21(2):136-138.
[2]Vonk MC,Sander MH,van den Hoogen FH,et al.Right ventricle Tei-index:a tool to increase the accuracy of non-invasive detection of pulmonary arterial hypertension in connective tissue diseases.Eur J Echocardiogr,2007,8(5):317-321.
[3]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.中华超声医学杂志,2014,23(8):645-650.
[4]Tei C.New noninvasive index for combined systolic and diastolic ventricular function.J Cardial,1995,26(2):135-136.
[5]王琨,谢红宁,李丽娟,等.应用Tei指数评价正常和宫内缺氧胎儿心功能.中华生物医学工程杂志,2014,20(3):191-194.
[6]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.Pediatr Cardiol,2013,34(8):1808-1815.
[7]Friedman D,Buyon J,Kim M,et a1.Fetal cardiac function assessed by DoppIer myocardial performance index(Tei index).UItrasound Obstet Gynecol,2003,21(1):33-36.
[8]Tsutsumi T,Ishii M,Eto G,et al.Serial evaluation for myocardial performance in fetuses and neonates using a new Doppler index.Pediatr Int,1999,41(6):722-727.
[9]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.中国医学影像学杂志,2010,18(4):315-317.
[10]Matter M,Abdel-Hady H,Attia G,et al.Myocardial performance in asphyxiated full-term infants assessed by Doppler tissue imaging.Pediatr Cardiol,2010,31(5):634-642.
[11]章鸣,周启昌,彭清海,等.组织多普勒成像评价正常胎儿左、右室Tei指数的研究.中国超声医学杂志,2005,21(2):136-138.