ABSTRACT
Objective To investigate clinical value of right ventricular morphology in children with congenital heart disease associated pulmonary hypertension. Methods From October 2014 to October 2017, 37 children with congenital heart disease without associated pulmonary hypertension ( resting pulmonary systolic pressure ≤30 mmHg,1 mmHg＝0. 133 kPa) were selected as group A. Thirty-seven children with congenital heart disease and associated pulmonary hypertension (resting pulmonary systolic pressure＞30 m) . were in group B,and 37 healthy children were in control group. Echocardiography was performed to compare the results of right ventricular morphology and systolic function in three groups. Results ( 1 ) Right ventricular morphology indexes:right atrium upper and lower diameter((56. 8±4. 0) mm),right atrium left and right diameter((49. 2± 3. 3) mm),right ventricle basal segment inner diameter(( 43. 7± 2. 5) mm), right ventricle medial diameter((41. 7±3. 9) mm),right ventricle long axis distance((73. 4±6. 2) mm), sternum sidelines right ventricular outflow tract proximal end diameter((37. 8± 2. 4) mm),short axis view right ventricular outflow tract distal internal diameter (( 33. 6 ± 2. 1) mm),main pulmonary artery internal diameter((30. 5± 2. 5) mm), right ventricle end diastolic area (( 31. 6 ± 1. 8) cm2 ), right ventricle end systolic area((19. 0± 2. 7) cm2 ) in group B were higher than those in group A((46. 2± 3. 1) mm,( 40. 4 ±2. 8) mm,(34. 6±2. 2) mm,(32. 5±2. 6) mm,(65. 1±4. 7) mm,(30. 2±2. 0) mm,( 29. 4±1. 8) mm, (23. 0±1. 6) mm,(22. 5±1. 1) cm2,(11. 6±1. 2) cm2)and control group((45. 3±2. 6) mm,(39. 5±1. 7) mm,(34. 0±1. 9) mm,(31. 8± 2. 0) mm,(63. 2± 3. 8) mm,( 29. 6± 1. 7) mm,(28. 9± 1. 5) mm,(22. 4 ±1. 4) mm,(22. 1±1. 0) cm2,(11. 3±0. 9) cm2),( F＝140. 26,147. 47,223. 08,130. 46,43. 56,183. 33, 74. 71,209. 94,587. 99,221. 34, all P＜0. 01 ) . ( 2) Right ventricle contractile function indexes : right ventricular area change rate((40. 1±1. 6)%),three tricuspid ring systolic displacement((2. 2±0. 2) cm), tricuspid valve peak systolic flow velocity((13. 8±0. 9) cm／s)in group B were lower than those in group A ((46. 3±1. 7)%,(2. 5±0. 3) cm,(16. 7±1. 2) cm／s)and control group((46. 8±1. 5)%,(2. 6±0. 3) cm, (17. 2±1. 4) cm／s),the difference was statistically significant(F＝200. 81,21. 86,88. 85,all P＜0. 01 ) . Conclusion Children with congenital heart disease associated pulmonary hypertension have right ventricle morphological changes and right ventricular systolic function decreasing. Right ventricular morphological examination has important clinical value.
ABSTRACT
Objective To study the sonographic features of fetal lung in normal and preeclampic pregnancies,with follow-up on the occurrence of neonatal respiratory distress syndrome (NRDS),as well as,examine the effects of preeclampsia (PE) on fetal lung maturity (FLM).Methods We collected data from 140 cases during the early pregnancy period (29 to ＜34 weeks),100 cases during the late pregnancy period (34 to 39 weeks),as well as 240 cases of normal pregnancies with the same gestational ages for the contwl group.Data included the parameters of fetal lung maturity measured by ultrasound and the incidence of NRDS postpartum.We analyzed the effects of PE on fetal lung maturity.Results The right fetal lung from the early onset PE group was significantly smaller than that of the normal group.There was no difference in the right lung area between the PE group and the normal group of the same gestational age.Compared with the normal group of the same gestational age,the LHR group had no difference in the early and late PE groups.The acceleration time/ejection time of the main pulmonary artery in the early and late PE group was significantly higher than that of the normal group.There was no difference in the incidence of NRDS among all the groups of the same gestational age.Conclusion PE has no significant effect on fetal lung function or maturation of the pulmonary tissues.Lung maturation may precede the same gestational age without PE.