大动脉转位(TGA)是最常见和最严重的先天性心脏病之一。新生儿稳定后,等待手术矫正,必须进行超声心动图监测并仔细评估左心室(LV)的性能。在这项研究中,我们的目标是(I)比较心肌功能,通过斑点追踪超声心动图评估,在患有TGA的新生儿和没有TGA的新生儿之间,以及(ii)确定对TGA具有良好判别能力的应变参数。我们做了一个回顾,单中心研究。共检查了90名新生儿,其中66人被纳入(16人被纳入TGA组,50人被纳入对照组)。双变量分析的结果表明,经典的超声心动图参数在两个研究组之间没有显着差异(EFp=0.785,对于MAPSE,p=0.286,对于TAPSE,p=0.315)。我们发现两组之间的LVpGLS参数的平均值具有统计学上的显着差异(调整后的p=0.0047),在调整其他协变量后,在TGA组中观察到LV心肌功能受损。关于节段性应变,发现TGA新生儿的平均内侧和心尖室间隔应变值显着低于对照组(均值差异的95%CI:[-6.45,-0.65],[-8.56,-1.97])。ROC分析结果表明,LVpGLS具有区分TGA新生儿和对照组的显着能力(AUC=0.712,95%CI:[0.52,0.903],p=0.011)。总之,LVpGLS是对LV功能障碍具有显著辨别能力的参数,对TGA评价新生儿心室心肌功能具有重要意义。
The transposition of great arteries (TGA) is one of the most frequent and severe congenital heart diseases. After newborn stabilization and while pending surgical correction, echocardiographic monitoring with a careful evaluation of left ventricle (LV) performance is warranted. In this
study, our objectives were (i) to compare myocardial function, assessed via speckle-tracking echocardiography, between neonates with TGA and neonates without TGA and (ii) to identify a strain parameter with a good discriminatory ability for TGA. We conducted a retrospective, single-center
study. A total of 90 neonates were examined, of whom 66 were included (16 comprised the TGA group and 50 comprised the control group). The results of a bivariate analysis showed that classic echocardiography parameters displayed no significant differences between the two studied groups (p = 0.785 for EF, p = 0.286 for MAPSE and p = 0.315 for TAPSE). We found a statistically significant difference between the two groups for the mean values of the LVpGLS parameter (adjusted p = 0.0047), with impaired LV myocardium function being observed in the TGA group after adjusting for other covariates. Regarding segmental strain, the mean medial and apical inter-ventricular septum strain values were found to be significantly lower in the neonates with TGA than in the controls (95% CI for difference in means: [-6.45, -0.65], [-8.56, -1.97]). The results of an ROC analysis showed that LVpGLS had a significant ability to differentiate between neonates with TGA and controls (AUC = 0.712, 95% CI: [0.52, 0.903], p = 0.011). In conclusion, LVpGLS is a parameter with a significant discriminatory ability for LV dysfunction, and it is useful in the evaluation of ventricular myocardial function in newborns with TGA.