Comparison of echocardiographic measurements to invasive measurements of diastolic function in infants with single ventricle physiology: a report from the Pediatric Heart Network Infant Single Ventricle Trial.
Comparison of echocardiographic measurements to invasive measurements of diastolic function in infants with single ventricle physiology: a report from the Pediatric Heart Network Infant Single Ventricle Trial.
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单心室生理学婴儿的超声心动图测量与侵入性舒张功能测量的比较：儿科心脏网络婴儿单心室试验的报告。
DOI：
10.1017/s1047951119001859
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发表时间：
2019
影响因子：
1
通讯作者：
Shrader,Pe
中科院分区：
文献类型：
--
作者：
Goudar,SumaP;Zak,Victor;Atz,AndrewM;Altmann,Karen;Colan,StevenD;Falkensammer,ChristineB;Friedberg,MarkK;Frommelt,Michele;Hill,KevinD;Hsu,DaphneT;Levine,JamiC;Margossian,Renee;Mart,ChristopherR;Sticka,Joshua;Shrader,Pe
背景虽然超声心动图参数用于量化单心室生理学婴儿的心室功能，但很少有数据将这些参数与侵入性测量进行比较。本研究将超声心动图测量的单心室生理学婴儿上腔静脉肺吻合术之前的舒张功能与心室舒张末压相关联。方法分析了参加儿科心脏网络婴儿单心室依那普利试验的 173 名患者的数据。混合心室类型 (n = 17) 和一名异常值 (舒张末压 = 32 mmHg) 的患者被排除在分析之外，总共留下 155 名患者。使用 Spearman 检验将超声心动图测量结果与舒张末压相关。结果超声心动图检查的中位年龄为 4.6 个月（范围 2.5-7.4）个月。心室舒张末期中位压为 7（范围 3-19）mmHg。超声心动图和导管插入术之间的中位时间差为 0 天（范围 -35 至 59 天）。对 155 名患者的整个队列进行检查，没有发现超声心动图舒张功能变量与心室舒张末压相关。当分析仅限于两项研究中镇静效果相似的 86 名患者时，收缩期：舒张期持续时间比与舒张末压呈显着但较弱的负相关（r = -0.3，p = 0.004）。其余的超声心动图变量与心室舒张末期压力无关。结论在上腔静脉肺吻合术之前具有单心室生理学的婴儿队列中，舒张功能的大多数常规超声心动图测量与心导管插入术时的心室舒张末期压力不相关。在解释该患者群体的定量回波数据时应考虑这些限制。
BackgroundWhile echocardiographic parameters are used to quantify ventricular function in infants with single ventricle physiology, there are few data comparing these to invasive measurements. This study correlates echocardiographic measures of diastolic function with ventricular end-diastolic pressure in infants with single ventricle physiology prior to superior cavopulmonary anastomosis.MethodsData from 173 patients enrolled in the Pediatric Heart Network Infant Single Ventricle enalapril trial were analysed. Those with mixed ventricular types (n = 17) and one outlier (end-diastolic pressure = 32 mmHg) were excluded from the analysis, leaving a total sample size of 155 patients. Echocardiographic measurements were correlated to end-diastolic pressure using Spearman’s test.ResultsMedian age at echocardiogram was 4.6 (range 2.5–7.4) months. Median ventricular end-diastolic pressure was 7 (range 3–19) mmHg. Median time difference between the echocardiogram and catheterisation was 0 days (range −35 to 59 days). Examining the entire cohort of 155 patients, no echocardiographic diastolic function variable correlated with ventricular end-diastolic pressure. When the analysis was limited to the 86 patients who had similar sedation for both studies, the systolic:diastolic duration ratio had a significant but weak negative correlation with end-diastolic pressure (r = −0.3, p = 0.004). The remaining echocardiographic variables did not correlate with ventricular end-diastolic pressure.ConclusionIn this cohort of infants with single ventricle physiology prior to superior cavopulmonary anastomosis, most conventional echocardiographic measures of diastolic function did not correlate with ventricular end-diastolic pressure at cardiac catheterisation. These limitations should be factored into the interpretation of quantitative echo data in this patient population.