Abstract:
The prevalence of interatrial communications in newborns, i.e., patent foramen ovale or atrial septal defect, was previously reported to be between 24 and 92%, but the area has been impeded by lack of a universal classification method. A recently published novel echocardiographic diagnostic algorithm for systematic classification of interatrial communications had inter-and intraobserver agreements superior to standard expert assessment. This study aimed to determine the prevalence of subtypes of interatrial communications on transthoracic echocardiography in newborns. Echocardiograms of newborns aged 0-30 days were prospectively collected in the population-based cohort study Copenhagen Baby Heart Study in 2017-2018 and analyzed according to the new diagnostic algorithm, classifying interatrial communications into three subtypes of patent foramen ovale and three subtypes of atrial septal defects. Echocardiograms from 15,801 newborns were analyzed; 3416 (21.6%) were excluded due to suboptimal image quality or severe structural heart disease (n = 3), leaving 12,385 newborns (aged 12 [interquartile range 8; 15] days, 48.2% female) included in the study. An interatrial communication was detected in 9766 (78.9%) newborns. According to the algorithm, 9029 (72.9%) had a patent foramen ovale, while 737 (6.0%) fulfilled criteria for an atrial septal defect, further divided into subtypes. An interatrial communication was seen on echocardiography in almost 80% of newborns aged 0-30 days. Patent foramen ovale was 12 times more frequent than atrial septal defects. The observed prevalence of atrial septal defects was higher than previously reported. Follow up studies could distinguish which interatrial communications require follow-up or intervention. ClinicalTrial.gov, NCT02753348, posted April 27, 2016, [ https://classic.clinicaltrials.gov/ct2/show/NCT02753348 ].
摘要:
新生儿心房通信的患病率,即,卵圆孔未闭或房间隔缺损,以前报道的比例在24%到92%之间,但是由于缺乏通用的分类方法,该地区受到了阻碍。最近发布的用于心房通信系统分类的新型超声心动图诊断算法具有优于标准专家评估的观察者间和观察者内协议。这项研究旨在确定新生儿经胸超声心动图中房间通信亚型的患病率。在2017-2018年基于人群的队列研究哥本哈根婴儿心脏研究中,前瞻性收集0-30天新生儿的超声心动图,并根据新的诊断算法进行分析。将房间通讯分为卵圆孔未闭的三种亚型和房间隔缺损的三种亚型。分析了15,801例新生儿的超声心动图;3416例(21.6%)由于图像质量欠佳或严重的结构性心脏病(n=3)而被排除在外。留下12,385名新生儿(年龄为12[四分位距8;15]天,48.2%女性)纳入研究。在9766例(78.9%)新生儿中检测到房间通讯。根据算法,9029(72.9%)卵圆孔未闭,737(6.0%)符合房间隔缺损的标准,进一步分为亚型。在0-30天的新生儿中,近80%的超声心动图观察到房间通讯。卵圆孔未闭的频率是房间隔缺损的12倍。观察到的房间隔缺损的患病率高于先前的报道。后续研究可以区分哪些心房通信需要随访或干预。ClinicalTrial.gov,NCT02753348,发布于2016年4月27日,[https://classic。clinicaltrials.gov/ct2/show/NCT02753348]。