经导管关闭婴幼儿动脉导管未闭后左心室大小和功能的变化

Change of left ventricular size and function in infants with patent ductus arteriosus after transcatheter closure

目的评价经导管封堵婴幼儿动脉导管前、后左心房及左心室的大小及左心室收缩功能的变化。方法选择2011年11月到2012年12月经临床及经胸超声心动图诊断为动脉导管未闭(PDA)的患儿50例为研究对象。对患儿经导管封堵动脉导管术前及术后24 h、1个月、3个月、6个月进行经胸超声心动图随诊,测量左心室舒张末内径(LVDd)、左心室收缩末内径(LVDs)、左心房内径(LA)、计算左心室射血分数(LVEF)、左心室短轴缩短率(LVFS)。结果患儿左心室舒张末内径、左心室收缩末内径、左心房内径术后明显减小,并在随访中持续下降,术后6个月达到平衡。左心室射血分数、左心室短轴缩短率短期内下降,术后3个月恢复到术前水平。结论经导管封堵婴幼儿动脉导管未闭后左心室及左心房明显缩小术后6个月左心室功能及左心房大小恢复平衡。左心室收缩功能短暂下降,术后3个月能恢复到正常。

Objectives To evaluate the change of left ventricular size and function and left atrial size in infants with patent ductus arteriosus （PDA） after transcatheter closure. Methods We analyzed 50 infants diagnosed as PDA by clinical events and transthoracic echocardiography from November 2011 to December 2012. Left ventricular diastolic and systolic dimensions （LVDd and LVDs）, left atrial dimension （LA）, left ventricular ejection fraction （LVEF） and left ventricular fractional shortening （LVFS） were examined by two-dimensional echocardiography before transcatheter occlusion, 24 h, 1 month, 3 months and 6 months after procedure. Results Left ventricular diastolic and systolic dimensions, left atrial dimension decreased at 24 h after procedure, and gradually achieved a balance in 6 months. Left ventricular ejection fraction and fractional shortening decreased in a short time and recovered to the preprocedural level in 3 months. Conclusions Left ventricular size and function and left atrial size decreased after percutaneous closure. Left ventricular function recovered to preprocedural level in 3 months, and left ventricalar and atrial sizes restored to equilibrium in 6 months after procedure.