Research On Right Ventricular Function In Neonates With Hypoxic Pulmonary Hypertension By Tissue Velocity Doppler Imaging Technology And Tei Index

Objective: To investigate the roles of the tissue velocity Doppler imaging (TVI) technology and Tei index in assessed right ventricular function in neonates with hypoxia-induced pulmonary artery hypertension (HPH). Methods: Echocardiographic examinations were performed on day 3 on 75 cases HPH group (which include of 29 cases mild HPH, 21 cases moderate HPH, 25 cases severe HPH) and 22 cases of neonates as control group, and pulmonary artery systolic pressure (PASP), right ventricular ejection fraction (RVEF), tricuspid early diastolic peak (peak E), the late diastolic peak (peak A) were estimated, and E/A ratio were acquired. The Tei index of right ventricular (RV-Tei) was measured by Doppler spectrum. The TVI indicator of the tricuspid valve in right ventricle (including systolic wave-Sa, early diastolic wave-Ea, and late diastolic wave-Aa) were measured, then Ea/Aa value were calculated. Result: 1) Compared the neonates of HPH groups with the control group, the RVEF and E/A ratio of right ventricle were decreased in severe HPH group and it was statistically significant (P<0.01), the other two groups were totally same, there was no statistical difference. 2) The RV-Tei in three HPH groups were higher than the control group (P<0.01). RV-Tei and PASP in HPH group was positively correlated (r=0.75, P<0.05), but has no correlation with gestational age, heart rate. 3) The value of Sa in mild HPH group has no statistically difference compared with the control group, but was lower than the control group in moderate and severe HPH group(Pwas<0.05, <0.01); The value of Aa in mild HPH group has no statistically difference compared with the control group, but was higher in moderate HPH group(P<0.01), and was lower in severe HPH group (P<0.01); The value of Ea, Ea/Aa ratio were lower than the control group in each HPH groups (P<0.01). The right ventricular function in three HPH groups was decreased, and the diastolic function was first, especially the early diastolic function. Conclusion: Neonatal pulmonary artery hypertension can lead to disorders of the right ventricular function. RV-Tei index can evaluated early overall changes of the right ventricular function than conventional ultrasound technology in newborns with HPH. TVI technology can be used more sensitively to evaluate systolic and diastolic function of right ventricular in those newborns.