PDF(Pubmed)
Abstract：
UNASSIGNED: The role of cardiac left ventricle (LV) dysfunction in children with congenital diaphragmatic hernia (CDH) has gained increasing attention. The hernia allows abdominal mass to enter thorax and subsequently both dislocating and compressing the heart. The pressure on vessels and myocardium alters blood flow and may interfere with normal development of the LV. A dysfunctional LV is concerning and impacts the complex pathophysiology of CDH. Hence, assessing both the systolic and diastolic LV function in the newborn with CDH is important, and it may add value for medical treatment and prognostic factors as length of stay (LOS) in pediatric intensive care unit (PICU). LV strain is considered an early marker of systolic dysfunction used in the pediatric population. Left atrial (LA) strain is an echocardiographic marker of LV diastolic dysfunction used in the adult population. When filling pressure of the LV increases, the strain of the atrial wall is decreased. We hypothesized that reduced LA strain and LV strain are correlated with the LOS in the PICU of newborns with CDH.
UNASSIGNED: This retrospective observational cohort study included data of 55 children born with CDH between 2018 and 2020 and treated at Karolinska University Hospital, Sweden. Overall, 46 parents provided consent. Echocardiograms were performed in 35 children <72 h after birth. The LA reservoir strain (LASr), LV global longitudinal strain, LV dimensions, and direction of blood flow through the patent foramen ovale (PFO) were retrospectively assessed using the echocardiograms.
UNASSIGNED: Children with LASr <33% (n = 27) had longer stays in the PICU than children with LA strain ≥33% (n = 8) (mean: 20.8 vs. 8.6 days; p < 0.002). The LASr was correlated with the LOS in the PICU (correlation coefficient: -0.378; p = 0.025). The LV dimension was correlated with the LOS (correlation coefficient: -0.546; p = 0.01). However, LV strain was not correlated to LOS.
UNASSIGNED: Newborns with CDH and a lower LASr (<33%) had longer stays in the PICU than children with LASr ≥33%. LASr is a feasible echocardiographic marker of diastolic LV dysfunction in newborns with CDH and may indicate the severity of the condition.
UNASSIGNED: This retrospective observational cohort study included data of 55 children born with CDH between 2018 and 2020 and treated at Karolinska University Hospital, Sweden. Overall, 46 parents provided consent. Echocardiograms were performed in 35 children <72 h after birth. The LA reservoir strain (LASr), LV global longitudinal strain, LV dimensions, and direction of blood flow through the patent foramen ovale (PFO) were retrospectively assessed using the echocardiograms.
UNASSIGNED: Children with LASr <33% (n = 27) had longer stays in the PICU than children with LA strain ≥33% (n = 8) (mean: 20.8 vs. 8.6 days; p < 0.002). The LASr was correlated with the LOS in the PICU (correlation coefficient: -0.378; p = 0.025). The LV dimension was correlated with the LOS (correlation coefficient: -0.546; p = 0.01). However, LV strain was not correlated to LOS.
UNASSIGNED: Newborns with CDH and a lower LASr (<33%) had longer stays in the PICU than children with LASr ≥33%. LASr is a feasible echocardiographic marker of diastolic LV dysfunction in newborns with CDH and may indicate the severity of the condition.
摘要：
■心脏左心室（LV）功能障碍在先天性膈疝（CDH）儿童中的作用日益受到重视。疝气允许腹部肿块进入胸部，随后既脱位又压迫心脏。血管和心肌上的压力会改变血流，并可能干扰LV的正常发育。功能失调的LV涉及并影响CDH的复杂病理生理学。因此，评估CDH新生儿的收缩和舒张功能很重要，它可能为儿科重症监护病房（PICU）的药物治疗和预后因素增加价值。LV应变被认为是儿科人群中使用的收缩功能障碍的早期标志。左心房（LA）应变是成年人群中使用的LV舒张功能障碍的超声心动图标记。当低压充装压力增加时，心房壁的应变降低。我们假设减少的LA菌株和LV菌株与CDH新生儿PICU中的LOS相关。
■这项回顾性观察性队列研究包括2018年至2020年间出生并在卡罗林斯卡大学医院接受治疗的55名患有CDH的儿童的数据。瑞典。总的来说,46名父母表示同意。对35名出生后<72h的儿童进行了超声心动图检查。LA储层应变（LASr），低压全球纵向应变,低压尺寸,使用超声心动图回顾性评估通过卵圆孔未闭(PFO)的血流方向.
■LASr<33％（n=27）的儿童在PICU中的停留时间比LA菌株≥33％（n=8）的儿童更长（平均值：20.8vs.8.6天；p<0.002)。LASr与PICU中的LOS相关(相关系数:-0.378;p=0.025)。LV维度与LOS相关(相关系数:-0.546;p=0.01)。然而,LV菌株与LOS无关。
■患有CDH和LASr较低（<33％）的新生儿在PICU中的停留时间比LASr≥33％的儿童更长。LASr是CDH新生儿舒张性LV功能障碍的可行超声心动图标志物，可能表明病情的严重程度。
■这项回顾性观察性队列研究包括2018年至2020年间出生并在卡罗林斯卡大学医院接受治疗的55名患有CDH的儿童的数据。瑞典。总的来说,46名父母表示同意。对35名出生后<72h的儿童进行了超声心动图检查。LA储层应变（LASr），低压全球纵向应变,低压尺寸,使用超声心动图回顾性评估通过卵圆孔未闭(PFO)的血流方向.
■LASr<33％（n=27）的儿童在PICU中的停留时间比LA菌株≥33％（n=8）的儿童更长（平均值：20.8vs.8.6天；p<0.002)。LASr与PICU中的LOS相关(相关系数:-0.378;p=0.025)。LV维度与LOS相关(相关系数:-0.546;p=0.01)。然而,LV菌株与LOS无关。
■患有CDH和LASr较低（<33％）的新生儿在PICU中的停留时间比LASr≥33％的儿童更长。LASr是CDH新生儿舒张性LV功能障碍的可行超声心动图标志物，可能表明病情的严重程度。
