Journal of the Korean Pediatric Society 2000;43(9):1168-1173.
Published online September 15, 2000.
Postnatal Changes in Left Ventricular Performance in Early Neonatal Life
Sung Wook Yang1, Chan Wook Woo1, Jee Youn Lim1, Jung Hwa Lee1, Joo Won Lee1, Chang Sung Son1, Young Chang Tockgo1, Young Yoo2
1Department of Pediatrics, College of Medicine, Korea University, Seoul, Korea
2Department of Pediatrics, Seoul Dong-bu Municipal Hospital, Seoul, Korea
정상 신생아에서 출생후 시간 경과에 따른 좌심실 기능의 변화
양성욱1, 우찬욱1, 임지연1, 이정화1, 이주원1, 손창성1, 독고영창1, 유 영2
1고려대학교 의과대학 소아과학교실
2동부시립병원 소아과
Abstract
Purpose
: This study was undertaken to investigate changes in cardiac performance in early neonatal life by observing the changes of left ventricular(LV) function and volume according to the size of ductus arteriosus.
Methods
: The study group consisted of 21 full-term Cesarean section neonates who were admitted to the nursery of Korea University Hospital. We serially investigated the patency and size of the ductus at 2, 24, 120 hours after birth by two-dimensional echocardiography. The standard two-dimensional tracings of LV volume were obtained under the guidance of apical two- and four-chamber views. LV end-diastolic and end-systolic volumes were calculated using a biplanar Simpson's method.
Results
: LV end-diastolic volume was highest(3.44±0.4mm) at 2 hours of age(P<0.01), being constant from 24 to 120 hours. LV contractility, indicated by the mean normalized systolic ejection rate, remained constant during the whole period of investigation. The size of the ductus arteriosus was maximal at 2 hours after birth, and decreased significantly at 24 hours of age (P<0.01). The size of ductus arteriosus demonstrated a close linear correlation with the left ventricular end-diastolic volume(y=0.17x+2.92, r=0.59 : P<0.01).
Conclusion
: Changes in LV end-diastolic volume soon after birth depend on changes in ductus arteriosus flow, which in turn is affected by ductal diameter. Upon patency of the ductus arteriosus, the newborn left ventricle operates at maximal performance with only a limited capacity to increase contractility.
Key Words: Left ventricular function, Postnatal change, Neonate


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