Echocardiographic characteristics and clinical outcomes in fetuses with pulmonary stenosis or pulmonary atresia with intact ventricular septum

IF 2.3 4区 医学 Q2 PEDIATRICS
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引用次数: 0

Abstract

Objective

To summarize echocardiographic characteristics of the anatomy and hemodynamic and clinical outcomes in fetuses with isolated pulmonary stenosis (PS) or pulmonary atresia with intact ventricular septum (PA/IVS).

Methods

This was a single-center retrospective study of fetuses with isolated PS or PA/IVS. Echocardiographic variables and clinical outcomes after delivery were evaluated and compared.

Results

Between 2016 and 2021, 115 livebirths with isolated PS or PA/IVS were included. Proportion of fetuses with mild, moderate and critical PS and PA/IVS was 41.7 %, 18.3 %, 26.1 % and 13.9 %. Fetuses with more severe PS had worse anatomic and hemodynamic profiles. Specifically, the cardiothoracic ratio, pulmonary valve (PV) velocity, degree and velocity of tricuspid regurgitation increased as PS severity increased; and the pulmonary artery/aorta ratio, right ventricle/left ventricle long-axis (TV/MV) ratio, tricuspid valve/mitral valve annulus (TV/MV) ratio, and tricuspid valve inflow duration/cardiac cycle ratio decreased as PS severity increased (P <0.001 for all). PV velocity ≥2 m/s predicted PV pressure ≥40 mm Hg after delivery, with an AUC of 0.81; TV/MV ratio combined with RV/LV ratio predicted clinical outcomes, with an AUC of 0.88. Live births with more severe PS had higher mortality rate (mild 0 vs. moderate 0 vs. critical 11 % vs. PA-IVS 36 %) and lower rate of developing bi-ventricles (mild 100 % vs. moderate 95 % vs. critical 89 % vs. PA-IVS 36 %).

Conclusion

Findings of this study help better understand the anatomy and hemodynamic and clinical outcomes in fetuses with isolated PS or PA/IVS, which could have implications for prenatal counseling and prediction of fetal outcome.

室间隔完整的肺动脉狭窄或肺动脉闭锁胎儿的超声心动图特征和临床结果。
目的:总结孤立性肺动脉狭窄(PS)或室间隔完整的肺动脉闭锁(PA/IVS)胎儿的超声心动图解剖、血液动力学和临床结果。方法:这是一项对患有孤立性PS或PA/IVS的胎儿的单中心回顾性研究。对分娩后的超声心动图变量和临床结果进行评估和比较。结果:2016年至2021年间,纳入115例患有孤立性PS或PA/IVS的活产婴儿。轻度、中度和重度PS和PA/IVS的胎儿比例分别为41.7%、18.3%、26.1%和13.9%。重度PS的胎儿解剖和血流动力学特征较差。具体而言,心胸比值、肺动脉瓣(PV)速度、三尖瓣反流程度和速度随着PS严重程度的增加而增加;以及肺动脉/主动脉比率、右心室/左心室长轴(TV/MV)比率、三尖瓣/二尖瓣环(TV/MW)比率,随着PS严重程度的增加,三尖瓣流入持续时间/心动周期比率降低(P结论:本研究的结果有助于更好地了解孤立性PS或PA/IVS胎儿的解剖结构、血液动力学和临床结果,这可能对产前咨询和预测胎儿结局有意义。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
3.10
自引率
0.00%
发文量
170
审稿时长
48 days
期刊介绍: Pediatrics and Neonatology is the official peer-reviewed publication of the Taiwan Pediatric Association and The Society of Neonatology ROC, and is indexed in EMBASE and SCOPUS. Articles on clinical and laboratory research in pediatrics and related fields are eligible for consideration.
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