Serial Assessment of Cardiac Function and Pulmonary Hemodynamics in Infants With Down Syndrome

被引：6

作者：

Smith, Aisling ^{[1
]}

Bussmann, Neidin ^{[1
]}

Breatnach, Colm ^{[1
]}

Levy, Philip ^{[1
,2
,3
]}

Molloy, Eleanor ^{[4
,5
]}

Miletin, Jan ^{[4
]}

Curley, Anna ^{[6
]}

McCallion, Naomi ^{[1
,7
]}

Franklin, Orla ^{[8
]}

El-Khuffash, Afif ^{[7
]}

机构：

[1] Rotunda Hosp, Dept Neonatol, Dublin, Ireland

[2] Boston Childrens Hosp, Dept Pediat, Boston, MA USA

[3] Harvard Med Sch, Dept Pediat, Boston, MA 02115 USA

[4] Coombe Women & Infants Univ Hosp, Dept Neonatol, Dublin, Ireland

[5] Trinity Coll Dublin, Dept Paediat & Child Hlth, Dublin, Ireland

[6] Natl Matern Hosp, Dept Neonatol, Dublin, Ireland

[7] Royal Coll Surgeons Ireland, Dept Paediat, Dublin, Ireland

[8] Childrens Hlth Ireland Crumlin, Dept Paediat Cardiol, Dublin, Ireland

来源：

JOURNAL OF THE AMERICAN SOCIETY OF ECHOCARDIOGRAPHY | 2022年 / 35卷 / 11期

关键词：

Down syndrome; Pulmonary hypertension; Deformation; Left ventricle; Right ventricle; SPECKLE-TRACKING; CHILDREN; ECHOCARDIOGRAPHY; TRISOMY-21; REPRODUCIBILITY; FEASIBILITY; ASSOCIATION; PROTOCOL; DISEASE; STRAIN;

D O I：

10.1016/j.echo.2022.07.012

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background: There is a dearth of longitudinal data describing the evolution of cardiopulmonary hemodynamics in infants with Down syndrome (DS) beyond infancy. We hypothesized that babies with DS, independent of the presence of congenital heart disease (CHD), demonstrate biventricular systolic and diastolic impairment and sustained elevation of pulmonary pressures compared with controls over the first 2 years of age. Methods: This was a prospective observational cohort study of 70 infants with DS (48 with CHD and 22 without CHD) and 60 controls carried out in 3 tertiary neonatal intensive care units in Dublin, Ireland. Infants with DS with and without CHD and non-DS controls underwent serial echocardiograms at birth, 6 months, 1 year, and 2 years of age to assess biventricular systolic and diastolic function using deformation analysis. Pulmonary vascular resistance was assessed using pulmonary artery acceleration time and left ventricular (LV) eccentricity index. Results: Infants with DS exhibited smaller LV (birth: 27 +/- 4 vs 31 +/- 2 mm, P < .01; 2 years: 43 +/- 5 vs 48 +/- 4 mm, P < .01) and right ventricular (birth: 28 +/- 3 vs 31 +/- 2 mm, P < .01; 2 years: 40 +/- 4 vs 44 +/- 3 mm, P < .01) lengths and lower LV (birth: -19% +/- 3% vs -22% +/- 2%, P < .01; 2 years: -24% +/- 2% vs -26% +/- 2%, P < .01) and right ventricular (birth: -19% +/- 4% vs -22% +/- 3%, P < .01; 2 years: -29% +/- 6% vs -33% +/- 4%, P < .01) systolic strain over the 2-year period. Pulmonary artery acceleration time was lower in the DS group throughout the study period (birth: 44 +/- 10 vs 62 +/- 14 ms, P < .01; 2 years 71 +/- 12 vs 83 +/- 11 ms, P < .01). No differences were observed between DS infants with and without CHD (all P > .05). Conclusions: Infants with DS exhibit impaired maturational changes in myocardial function and pulmonary vascular resistance. Such novel findings provide valuable insights into the pathophysiology affecting cardiorespiratory morbidity in this population.

引用

页码：1176 / +

页数：13

共 38 条

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