The Study Of Ventricular Function And Hemodynamics In Newborn Infants

Objective (1) To detect the left and right ventricular function and hemodynamic parameters in different phases by Echocardiography.(2) To analysis the influence factors of ventricular function in normal newborn infants.Methods The left and right ventricular function was examined by Philips IE33color Doppler ultrasonic diagnostic apparatus in100cases of normal newborn infants(forty-five preterm infants and fifty-five term-birth infants). The parameters of the left ventricular systolic function included peak flow rate of aorta valve orifice (AV),stroke volume (SV), left ventricular end systolic volume (LVESV),left ventricular end diastolic volume (LVEDV), left ventricular systolic function (LVSF), left ventricular ejection fraction (LVEF); The parameters of the right ventricular systolic function included peak flow rate of pulmonary artery valve orifice (PV);The left and right ventricular diastolic function included the ratio of early (E) and late (A) diastolic velocities of bicuspid and tricuspid valves (MVE/A, TVE/A), One hundred newborn infants were divided into three groups according to the gestational age which was28～31+6,32～36+6and37～41+6weeks respectively, the ventricular function of newborn infants with different gestational age were compared. The infants were divided into two groups according to the time at examination as d1～d7, and d8～d28, the ventricular function of preterm and term newborn infants with different time were compared.. The influence factors of left ventricular function were determined by multiple linear regression analysis. Results (1)The AV, SV,LVESV,LVEDV,LVSF and LVEF increased with the increasing of gestational age. The AV, SV,LVESV,LVEDV,LVSF and LVEF of premature group at gestational age of28～31+6and32～36+6weeks were lower than those of full-term group at gestational age of37～40+1weeks, respectively (P<0.05). The AV, SV,LVESV,LVEDV,LVSF and LVEF increased with the increasing of the time in premature group. There was a significant difference between group dl-d7and d8-d28.(P<0.05, respectively), and the LVSF and LVEF increased with the increasing of the time in full-term group.(P<0.05). The rest was not statistically significant.(P>0.05).(2)The MVE/A increased with the increasing of gestational age. The MVE/A of premature group at gestational age of28～31+6and32～36+6weeks were lower than those of full-term group at gestational age of37～40+6weeks, respectively (P<0.05). The MVE/A increased with the increasing of the time in premature group. There was a significant difference between group d1～d7and d8～d28.(P<0.05, respectively). and no significant difference between group d1～d7and d8～d28in full-term group.(P>0.05).(3)The TVE/A increased with the increasing of gestational age. The TVE/A of premature group at gestational age of28～31+6and32～36+6weeks were lower than those of full-term group at gestational age of37～40+1weeks, respectively (P<0.05). The TVE/A increased with the increasing of the time in premature group. There was a significant difference between group d1～d7and d8～d28.(P<0.05). and no significant difference between group d1～d7and d8～d28in full-term group.(P>0.05).(4)The PV increased with the increasing of gestational age. The PV of premature group at gestational age of28～31+6and32～36+6weeks were lower than those of full-term group at gestational age of37～40+1weeks, respectively (P<0.05). The PV increased with the increasing of the time in premature group. There was a significant difference between group d1～d7and d8-d28.(P<0.05, respectively). and no significant difference between group d1～d7and d8～d28in full-term group.(P>0.05).(5)The AV,PV,SV,LVSF,LVEF,MVE/A and TVE/A were positively related to birth weight, gestational age and the time at examination.(respectively, P<0.05);)The AV of baby boy was obviously higher than that of the baby girl (P<0.05). The rest was not statistically significant.(P>0.05). Each index has nothing to do with born way.(P>0.05).Conclusions (1)The left and right ventricular systolic and diastolic function gradually increased with the increasing of gestational age.(2)The left and right ventricular systolic function gradually increase after delivery in the first month of life.Compared with right ventricular systolic function, the left ventricular systolic function increases more obviously. but the diastolic function of right ventricle does not increase significantly.(3)The ventricular systolic and diastolic function of premature group were lower than those of full-term group.(4)The birth weight, gestational age and the time at examination are important influence factors of the ventricular function in newborn infants. However, sex and born way are not key factors of the ventricular function.