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Evaluation of Pulmonary Venous, Mitral and Aortic Flow Pattern by Doppler Echocardiography in Neonates

Journal of the Korean Pediatric Society 1994;37(5):596-605.
Published online May 15, 1994.
Evaluation of Pulmonary Venous, Mitral and Aortic Flow Pattern by Doppler Echocardiography in Neonates
Hye Soon Kim, Young Mi Hong, Gyoung Hee Kim
Department of Pediatrics, College of Medicine, Ewha Wamans University, Seoul, Korea
Doppler 심에코도를 이용한 신생아기 폐정맥 승모판 및 대동맥판막 혈류에 관한 연구
김혜순, 홍영미, 김경희
이화여자대학교 의과대학 소아과학교실
Abstract
Pulmonary vein velocities have recently been estimated in conjunction with mitral flow velocities to increase our understanding of ventricular filling. The advent of transesophageal echocardiography with pulsed doppler imaging capability has provided a method by which both the mitral valve and pulmonary vein velocities can be easily recorded because of the posterior approach providing unimpeded interrogation of cardiac structures. The purpose of this present study was to evaluate the normal pulmonary venous, mitral and aortic flow pattern by transthoracic echocardiography in neonate according to the postnatal age. The results were as follows. 1) With regard to the aortic flow, the early systolic was of pulmonary flow peaked after the onset of aortic flow and the late systolic wave occurred consistently before aortic valve closure. 2) The peak velocities of early systolic, late systolic, diastolic and atrial systolic in the pulmonary venous flow were 36.4¡¾13.2cm/sec, 45.3¡¾15.3cm/sec and 16.6¡¾5.7cm/sec at 1 day old. The difference according to the postnatal age was not significant. 3) The ratio of peak systolic to peak distolic velocity of pulmonary venous flow was 1.0¡¾0.3 at 1 day ol, 1.1¡¾0.4 at 1 week old and 1.2¡¾0.3 at 1 month old. The difference between 1 week old and 1 month old was statistically significant (p<0.05). 4) The peak early diastolic velocity of mitral flow was 51.3¡¾15.2cm/sce at 1 day old, 54.7¡¾13.7cm/sec at 1 week old and 80.7¡¾16.6cm/sec at 1 month old. The difference between 1 week old and 1 month old was statistically significant (p0.01). 5) the Peak late diastolic velocity of mitral flow was 48.3¡¾14.6cm/sec at 1 day old. 50.1¡¾9.9cm/sec at 1 week old and 71.8¡¾16.6cm/sec at 1 month old. The difference between 1 week old and 1 month old was statistically significant (p<0.01) 6) The ratio of peak mitral early diastolic to peak late diastolic velocity was 1.1¡¾0.2 at 1 day old, 1.1¡¾0.3 at 1 week old and 1.2¡¾0.7 at 1 month old. The difference between 1 week old and 1 month old was statistically significant (p<0.01). 7) The peak aortic valve flow velocity was 62.1¡¾14.2cm/sec at 1 day 67.8¡¾13.4cm/sec at 1 week old and 76.6¡¾14.1cm/sec at 1 month old. The difference between 1 week old and 1 month old was statistically significant (p<0.05). In conclusion, improvement of left ventricular diastolic function was noted at 1 month old by echocardiography. These normal data will be useful in comprisons with the data, which obtained in newborn with various congenital heart disease that affects flow dynamics.
Key Words: Echocardiography, Pulmonary vein, Mitral Valve, Aortic Valve, Blood flow


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