Chinese Journal of Practical Pediatrics

Chinese Journal of Practical Pediatrics ›› 2025, Vol. 40 ›› Issue (8): 691-699.DOI: 10.19538/j.ek2025080614

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Establishment of reference ranges for left ventricular functional parameters in neonatal echocardiography：a multicenter，prospective，observational study

  

  1. *Department of Neonatology，Children’s Hospital of Chongqing Medical University，National Clinical Research Center for Child Health and Disorders，Ministry of Education Key Laboratory of Child Development and Disorders，Key Laboratory of Children’s Vital Organ Development and Diseases of Chongqing Health Commission，Chongqing  400014，China
  • Online:2025-08-06 Published:2025-09-15

新生儿超声心动图左心功能参数参考范围构建：一项多中心、前瞻性、观察性研究

  

  1. 1.重庆医科大学附属儿童医院新生儿诊治中心  国家儿童健康与疾病临床医学研究中心  儿童发育疾病研究教育部重点实验室  重庆市卫生健康委儿童重要器官发育与疾病重点实验室，重庆  400014 ；2. 内蒙古自治区妇幼保健院新生儿科，内蒙古自治区  呼和浩特  010020 ；3. 银川市第一人民医院超声科，宁夏回族自治区  银川  750001 ；4. 内江市第一人民医院新生儿科，四川  内
    江  641099
  • 通讯作者: 董文辉；电子信箱：481974@hospital.cqmu.edu.cn
  • 基金资助:
    国家重点研发计划资助项目（2022YFC2704805）；内蒙古自治区卫生健康委2023年首府地区公立医院高水平临床专科建设科技项目资助项目（2023SGGZ104）

Abstract: Objective　To establish reference ranges for left ventricular functional parameters in neonatal echocardiography across different postnatal time intervals，stratified by gestational age（GA），birth weight，and gender，thereby providing reference for left ventricular functional assessment in the application of neonatal critical care bedside cardiac ultrasound. Methods　This multicenter，prospective，observational study enrolled 406 term neonates hospitalized or receiving outpatient care at the Children’s Hospital of Chongqing Medical University，Yinchuan First People’s Hospital of Ningxia Autonomous Region，and Inner Mongolia Maternal and Child Health Hospital between June 2023 and May 2024. Bedside echocardiography was performed by trained neonatologists or sonographers to measure parameters reflecting left ventricular systolic and diastolic function. Reference ranges（95% confidence intervals）were established for postnatal days 1，3，7，14，and 28，with stratification by GA and birth weight. Results　Among the 406 term neonates（204 males，202 females），mean GA was（38.9±1.5）weeks，and mean birth weight was（3197.8±449.5）g. Multiple left ventricular functional parameters—including left ventricular outflow tract stroke volume（LVO），weight-indexed LVO（LVO*），mitral annular plane systolic excursion（MAPSE），mitral valve early（MV-E）and late（MV-A）diastolic inflow velocities，and pulmonary vein S/D ratio—showed significant associations with birth weight and GA（all P<0.05）. LVO，LVO*，MV-E，MV-A，MV-E/e’ratio（early diastolic inflow velocity to lateral mitral annular tissue Doppler e’velocity），pulmonary vein S-wave velocity，and pulmonary vein S/D ratio were correlated with postnatal age（all P<0.05）. No parameters exhibited gender-related differences（all P>0.05）. Conclusion　Neonatal left ventricular systolic and diastolic functional parameters are associated with postnatal age，GA，and birth weight. This study establishes comprehensive reference ranges for left ventricular functional assessment，stratified by age，GA and birth weight，which play a crucial role in guiding refined hemodynamic evaluation and management of critically ill neonates.

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目的　建立新生儿不同时间段超声心动图左心功能参数参考范围，并根据孕周、出生体重及性别进行分层，为新生儿床旁重症心脏超声应用提供左心功能评估参考。方法　采用多中心、前瞻性、观察性研究方法，纳入2023年6月至2024年5月在重庆医科大学附属儿童医院、银川市第一人民医院、内蒙古自治区妇幼保健院住院或门诊就诊共406例足月儿。由经过超声培训的新生儿科临床医师或超声科医师进行新生儿床旁超声心动图检查，测量反映左心收缩及舒张功能的相关指标。采用95%置信区间的方法，建立生后1 d、3 d、7 d、14 d 和28 d的各个参数参考范围，并根据不同孕周和出生体重进行分层。结果　406例足月新生儿中，男204例、女202例，出生孕周（38.9±1.5）周，出生体重（3197.8±449.5）g。左心功能各参数中，左室流出道每搏心输出量（LVO）、单位体重左室流出道每搏心输出量（LVO* ）、二尖瓣环收缩期位移（MAPSE）、二尖瓣舒张期血流速度E峰（MVE）、A峰（MV-A）以及肺静脉S/D比值与出生体重、孕周均相关（P均<0.05）。LVO、LVO* 、MV-E、MV-A、二尖瓣舒张期血流速度上峰与环侧壁舒张早期心肌运动速度e' 比值（MV-E/e’）、肺静脉S峰、肺静脉S/D比值与生后日龄相关（P均<0.05）。所有左心功能参数与性别均无相关性（P均>0.05）。结论　新生儿左心室收缩及舒张功能较多参数均与生后日龄、孕周及出生体重相关。研究建立全面的左心功能评估参数的参考范围，并根据日龄、孕周及出生体重进行分层，旨在指导危重新生儿精细化血流动力学评估和管理。

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