血液动力学意义上的动脉导管未闭:导管大小对左输出量和主动脉多普勒测速的影响

Josephat Chinawa M, Edmund Ossai, Awoere Chinawa, Jude Onyia T
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引用次数: 0

摘要

患有动脉导管未闭(PDA)的儿童会出现不同程度的血液动力学状态。目前尚不清楚导管大小与血液动力学状态之间是否存在联系。本研究调查了血流动力学显著性 PDA(hsPDA)的患病率,并试图记录导管大小对左心输出量和主动脉多普勒测速的影响。这是一项横断面研究,评估了 3-19 岁儿童和青少年中 hsPDA 的患病率以及导管大小与左心室功能(LVF)参数之间的关系。患有 PDA 的受访者的平均左心室质量(LVM)为 8.3 ± 5.3,低于对照组的 14.3 ± 5.2,平均差异具有统计学意义(Mann-Whitney U = 7.270,p < 0.001)。小型、中型和大型 hsPDA 的发病率分别为 40.7%、35.6% 和 23.7%。最常见的 hsPDA 发病年龄为 1 个月大。PDA 大小与射血分数(EF)呈弱负相关,PDA 的增大与 EF 的减小相关,但未发现有统计学意义(n = 59,r = - 0.233,p = 0.076)。PDA 大小与血流速度呈弱正相关,PDA 大小的增加与血流速度的增加相关,但无统计学意义(n = 43,r = 0.252,p = 0.104)。本研究中 hsPDA 的发病率较高。健康儿童和青少年的左心室容积高于 PDA 患儿。PDA 儿童的左心室质量与降主动脉速度成反比。
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Hemodynamically Significant Patent Ducts Arteriosus: Impact of Ductal Size on Left Output and Aortic Doppler Velocimetry

Children with patent ductus arteriosus (PDA) present with several degrees of hemodynamic states. It is not known if there is any link between ductal size and hemodynamic states. This study elicited the prevalence of hemodynamically significant PDA (hsPDA) and attempted to document the impact of ductal size on left output and aortic Doppler velocimetry. This is a cross-sectional study that assessed the prevalence of hsPDA and the relationship of ductal size and parameters of left ventricular function (LVF) in children and adolescents aged 3–19 years. The mean left ventricular mass (LVM) for respondents with PDA, 8.3 ± 5.3, was lower than that of the control, 14.3 ± 5.2, and the mean difference was found to be statistically significant (Mann–Whitney U = 7.270, p < 0.001). The prevalence of small, moderate, and large hsPDA was 40.7%, 35.6%, and 23.7% respectively. The commonest age of presentation of hsPDA is 1 month of age. There was a weak negative correlation between PDA size and ejection fraction (EF), increases in PDA size correlate with decreases in EF, but this was not found to be statistically significant (n = 59, r = − 0.233, p = 0.076). There was a weak positive correlation between PDA size and velocity, increases in PDA size correlate with increases in velocity, and this was not found to be statistically significant (n = 43, r = 0.252, p = 0.104). The prevalence of hsPDA in this study was high. The LVM in healthy children and adolescents was higher than in those with PDA. Left ventricular mass in children with PDA correlates inversely with descending aorta velocity.

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