Abstract：
BACKGROUND: An inadequate clearance of lung fluid plays a key role in the pathogenesis of transient tachypnea of the newborn (TTN).
OBJECTIVE: To evaluate if left ventricular diastolic dysfunction contributes to reduced clearance of lung fluid in TTN.
METHODS: This was a prospective, observational study. Echocardiography and lung ultrasound were performed at 2, 24 and 48 h of life (HoL) to assess biventricular function and calculate lung ultrasound score (LUS). Left atrial strain reservoir (LASr) provided surrogate measurement of left ventricular diastolic function.
RESULTS: Twenty-seven neonates with TTN were compared with 27 controls with no difference in gestation (36.1 ± 2 vs. 36.9 ± 2 weeks) or birthweight (2508 ± 667 vs. 2718 ± 590 g). Biventricular systolic function was normal in both groups. LASr was significantly lower in cases at 2 (21.0 ± 2.7 vs. 38.1 ± 4.4; p < 0.01), 24 (25.2 ± 4.5 vs. 40.6 ± 4.0; p < 0.01) and 48 HoL (36.5 ± 5.8 and 41.6 ± 5.2; p < 0.01), resulting in a significant group by time interaction (p < 0.001), after adjusting for LUS and gestational diabetes. A logistic regression model including LUS, birth weight and gestational diabetes as covariates, showed that LASr at 2 HoL was a predictor of respiratory support at 24 HoL, with an adjusted odds ratio of 0.60 (CI 0.36-0.99).
CONCLUSIONS: LASr was reduced in neonates with TTN, suggesting diastolic dysfunction, that may contribute to the delay in lung fluid clearance.
OBJECTIVE: To evaluate if left ventricular diastolic dysfunction contributes to reduced clearance of lung fluid in TTN.
METHODS: This was a prospective, observational study. Echocardiography and lung ultrasound were performed at 2, 24 and 48 h of life (HoL) to assess biventricular function and calculate lung ultrasound score (LUS). Left atrial strain reservoir (LASr) provided surrogate measurement of left ventricular diastolic function.
RESULTS: Twenty-seven neonates with TTN were compared with 27 controls with no difference in gestation (36.1 ± 2 vs. 36.9 ± 2 weeks) or birthweight (2508 ± 667 vs. 2718 ± 590 g). Biventricular systolic function was normal in both groups. LASr was significantly lower in cases at 2 (21.0 ± 2.7 vs. 38.1 ± 4.4; p < 0.01), 24 (25.2 ± 4.5 vs. 40.6 ± 4.0; p < 0.01) and 48 HoL (36.5 ± 5.8 and 41.6 ± 5.2; p < 0.01), resulting in a significant group by time interaction (p < 0.001), after adjusting for LUS and gestational diabetes. A logistic regression model including LUS, birth weight and gestational diabetes as covariates, showed that LASr at 2 HoL was a predictor of respiratory support at 24 HoL, with an adjusted odds ratio of 0.60 (CI 0.36-0.99).
CONCLUSIONS: LASr was reduced in neonates with TTN, suggesting diastolic dysfunction, that may contribute to the delay in lung fluid clearance.
摘要：
背景：肺液清除率不足在新生儿短暂性呼吸急促（TTN）的发病机制中起关键作用。
目的：评估左心室舒张功能不全是否导致TTN肺液清除率降低。
方法：这是一个前瞻性的，观察性研究。在2、24和48h（HoL）进行超声心动图和肺部超声检查以评估双心室功能并计算肺部超声评分（LUS）。左心房应变储存器(LASr)提供左心室舒张功能的替代测量。
结果：将27例TTN新生儿与27例妊娠无差异的对照组进行了比较（36.1±2vs.36.9±2周）或出生体重（2508±667vs.2718±590g）。两组的双心室收缩功能均正常。LASr在2例（21.0±2.7vs.38.1±4.4；p<0.01），24（25.2±4.5vs.40.6±4.0；p<0.01）和48HoL（36.5±5.8和41.6±5.2；p<0.01），导致一组显著的时间相互作用(p<0.001)，在调整LUS和妊娠期糖尿病后。包括LUS的逻辑回归模型，出生体重和妊娠期糖尿病作为协变量，显示2HoL时的LASr是24HoL时呼吸支持的预测因子，调整后的比值比为0.60（CI0.36-0.99）。
结论：新生儿TTN的LASr降低，提示舒张功能障碍,这可能导致肺液清除延迟。
目的：评估左心室舒张功能不全是否导致TTN肺液清除率降低。
方法：这是一个前瞻性的，观察性研究。在2、24和48h（HoL）进行超声心动图和肺部超声检查以评估双心室功能并计算肺部超声评分（LUS）。左心房应变储存器(LASr)提供左心室舒张功能的替代测量。
结果：将27例TTN新生儿与27例妊娠无差异的对照组进行了比较（36.1±2vs.36.9±2周）或出生体重（2508±667vs.2718±590g）。两组的双心室收缩功能均正常。LASr在2例（21.0±2.7vs.38.1±4.4；p<0.01），24（25.2±4.5vs.40.6±4.0；p<0.01）和48HoL（36.5±5.8和41.6±5.2；p<0.01），导致一组显著的时间相互作用(p<0.001)，在调整LUS和妊娠期糖尿病后。包括LUS的逻辑回归模型，出生体重和妊娠期糖尿病作为协变量，显示2HoL时的LASr是24HoL时呼吸支持的预测因子，调整后的比值比为0.60（CI0.36-0.99）。
结论：新生儿TTN的LASr降低，提示舒张功能障碍,这可能导致肺液清除延迟。
