Asymmetrical Hemodynamic Influence of Twin-Twin Transfusion Syndrome on Fetal E/e' by the Dual Gate Doppler Method in Recipient Twins
Asymmetrical Hemodynamic Influence of Twin-Twin Transfusion Syndrome on Fetal E/e' by the Dual Gate Doppler Method in Recipient Twins
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双门多普勒法研究双胞胎输血综合征对胎儿 E/e 的不对称血流动力学影响
DOI：
10.1159/000501773
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发表时间：
2020
期刊：
影响因子：
2.2
通讯作者：
Morita M.
中科院分区：
文献类型：
--
作者：
Takano M;Nakata M;Nagasaki S;Morita M.
目的 使用双门多普勒 (DD) 方法在同一心动周期内测量左心室 (LV) 和右心室 (RV) E/e’，评估双胎输血综合征 (TTTS) 对舒张功能的血流动力学影响。 方法本研究包括 56 例接受胎镜激光手术的单绒毛膜双胎妊娠 (FLS) 2015-2018 年 TTTS。通过DD方法在FLS前24小时和FLS后4-7天测量E/e’。结果与捐赠者相比，I期、II期和III期受者(IIIr)的受者显示出更高的LV-E/e’Z分数，而III期供者和IIIr期的RV-E/e’Z分数高于供者(p<0.05)。 FLS 后，由于 LV-E 速度 Z 评分降低，受者的 LV-E/e’Z 评分显着降低（p < 0.05）。由于受者 RV-e’velocity Z 评分增加，FLS 后 RV-E/e’Z 评分显着下降（p<0.05）。结论 DD 方法的 E/e’ 有助于评估受者的心脏变化。 LV-E/e’可以通过TTTS评估早期血流动力学变化，RV-E/e’可以评估后期对心脏舒张功能的影响。此外，在受者双胞胎中，FLS 后 LV-E/e’ 的降低可能反映了容量超负荷的改善，而 RV-E/e’ 的降低可能反映了 RV 舒张舒张功能的改善。
ObjectivesTo assess the hemodynamic influence of twin-twin transfusion syndrome (TTTS) on diastolic function, using left ventricle (LV) and right ventricle (RV) E/e’measured in the same cardiac cycle using the dual-gate Doppler (DD) method.MethodsThis study included 56 monochorionic twin pregnancies that underwent fetoscopic laser surgery (FLS) for TTTS in 2015–2018. E/e’by the DD method was measured 24 h before and 4–7 days after FLS.ResultsRecipients showed higher LV-E/e’Z score in stage I-, II-, and III-recipients (IIIr) and higher RV-E/e’Z score in stage III-donors and IIIr than donors (p< 0.05). After FLS, LV-E/e’Z score of recipients significantly decreased due to LV-E velocity Z score decrease (p< 0.05). RV-E/e’Z score after FLS significantly decreased due to RV-e’velocity Z score increase in recipients (p< 0.05).ConclusionsE/e’by the DD method helped assess cardiac changes of recipients. LV-E/e’could assess early hemodynamic changes by TTTS, and RV-E/e’can assess later influence on cardiac diastolic function. Furthermore, in recipient twins, the decrease in LV-E/e’after FLS might reflect the improvement of volume overload and the decrease in RV-E/e’might reflect the improvement of diastolic relaxation function in the RV.