Persistence of right ventricular dysfunction and altered morphometry in asymptomatic preterm Infants through one year of age: Cardiac phenotype of prematurity.
Persistence of right ventricular dysfunction and altered morphometry in asymptomatic preterm Infants through one year of age: Cardiac phenotype of prematurity.
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无症状早产儿一岁时右心室功能障碍和形态改变的持续存在：早产儿的心脏表型。
DOI：
10.1017/s1047951119001161
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发表时间：
2019
影响因子：
1
通讯作者：
Levy,PhilipT
中科院分区：
文献类型：
--
作者：
Erickson,CollinT;Patel,MeghnaD;Choudhry,Swati;Bisselou,KarlStessy;Sekarski,Tim;Craft,Mary;Li,Ling;Khuffash,AfifEl;Hamvas,Aaron;Kutty,Shelby;Singh,GautamK;Levy,PhilipT
简介早产会影响心肌发育并可能决定长期结果。本研究的目的是检验以下假设：早产儿在月经后 32 周出现右心室功能障碍和适应性重构，并持续到校正年龄 1 岁。材料和方法从前瞻性入组队列中回顾性选择 80 名早产儿（出生 <29 周），并在月经后 32 周通过二维超声心动图评估右心室收缩功能和形态。年龄和 1 岁时的校正年龄。对 50 名 1 个月和 1 岁的足月婴儿进行了比较。对患有支气管肺发育不良和/或肺动脉高压的早产儿进行了亚组分析。 结果足月儿和早产儿的右心室功能和形态在第一年均有所增加（p < 0.01）。早产儿在每个时间段的右心室功能测量值均较低（所有早产儿均 p < 0.01），并且所有早产儿的右心室形态指数在 1 岁校正年龄时均较宽，无论肺部疾病与否。患有支气管肺发育不良和/或肺动脉高压的早产儿在 1 岁时，a) 右心室功能进一步下降，b) 形态有所增加 (p < 0.01)。 结论 早产儿表现出异常的右心室性能，并在月经后 32 周出现重构，并持续到 1 岁校正年龄，表明早产后内在心肌功能反应发育不良。支气管肺发育不良和肺动脉高压的发展在一岁时对右心室力学产生进一步的负面影响。
IntroductionPrematurity impacts myocardial development and may determine long-term outcomes. The objective of this study was to test the hypothesis that preterm neonates develop right ventricle dysfunction and adaptive remodelling by 32 weeks post-menstrual age that persists through 1 year corrected age.Materials and MethodsA subset of 80 preterm infants (born <29 weeks) was selected retrospectively from a prospectively enrolled cohort and measures of right ventricle systolic function and morphology by two-dimensional echocardiography were assessed at 32 weeks post-menstrual age and at 1 year of corrected age. Comparisons were made to 50 term infants at 1 month and 1 year of age. Sub-analyses were performed in preterm-born infants with bronchopulmonary dysplasia and/or pulmonary hypertension.ResultIn both term and preterm infants, right ventricle function and morphology increased over the first year (p < 0.01). The magnitudes of right ventricle function measures were lower in preterm-born infants at each time period (p < 0.01 for all) and right ventricle morphology indices were wider in all preterm infants by 1 year corrected age, irrespective of lung disease. Measures of a) right ventricle function were further decreased and b) morphology increased through 1 year in preterm infants with bronchopulmonary dysplasia and/or pulmonary hypertension (p < 0.01).ConclusionPreterm infants exhibit abnormal right ventricle performance with remodelling at 32 weeks post-menstrual age that persists through 1 year corrected age, suggesting a less developed intrinsic myocardial function response following preterm birth. The development of bronchopulmonary dysplasia and pulmonary hypertension leave a further negative impact on right ventricle mechanics over the first year of age.