title: Right Heart Function of Fetuses and Infants with Large Ventricular Septal Defect: A Longitudinal Case-Control Study.
abstract: The objective of this study was to detect the effect of a large ventricular septal defect (VSD) on right ventricular function before and after birth. All consecutive children with large VSD who were born in our hospital between January 2013-February 2016 and followed up throughout early infancy, and who lacked malformations or chromosomal abnormalities, were identified by a retrospective review of the medical records and included in this retrospective longitudinal case-control study (n = 30). Thirty normal control cases with an equivalent gestational age and gender served as controls. Tricuspid annular plane systolic excursion (TAPSE), right ventricle (RV) Tei index, and tricuspid E/Emwere measured in the fetal, neonatal (day 1-28), and infant (day 29-70) periods. In all periods, the VSD and control groups did not differ in TAPSE values, but VSD associated with higher Tei indices and tricuspid E/Emvalues (in the fetal period: VSD group RV Tei was 0.48 ± 0.12 and E/Emwas 11.84 ± 1.53, control group RV Tei was 0.42 ± 0.16 and E/Emwas 10.16 ± 1.61; in neonatal period: VSD group RV Tei was 0.41 ± 0.17 and E/Emwas 12.21 ± 1.59, control group RV Tei was 0.30 ± 0.13 and E/Emwas 7.20 ± 1.28; in the infant period: VSD group RV Tei was 0.39 ± 0.09 and E/Emwas 11.89 ± 2.80, control group RV Tei was 0.28 ± 0.12 and E/Emwas 5.26 ± 1.90, all p < 0.05). In the fetal and neonatal periods, TAPSE correlated negatively with Tei index and tricuspid E/Emin both groups. However, in the infant period, only the control group exhibited correlations between TAPSE and Tei index or tricuspid E/Em. Tei index correlated positively with tricuspid E/Emin both groups in all three periods. The VSD group had smaller correlation coefficients than the control group. Large VSD may already start to impair RV diastolic and global function before birth. This impairment continued and increased after birth. These changes did not associate with obvious RV longitudinal systolic function impairment. Large VSD mainly affected RV function by decreasing diastolic function and myocardial performance.
authors: Department of Ultrasonography, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China.|Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China.
authors: Jiao
authors: J
authors: Chen
authors: The Vascular Remodeling and Developmental Defects Research Unit, West China Institute of Women and Children's Health, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China.|Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China.
authors: Liang
authors: L
authors: Xie
authors: National Center for Birth Defect Monitoring, West China Second University Hospital, Sichuan University, Chengdu, China.|Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China.
authors: Li
authors: L
authors: Dai
authors: Department of Pediatric Cardiology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China.|Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China.
authors: Li
authors: L
authors: Yu
authors: The Vascular Remodeling and Developmental Defects Research Unit, West China Institute of Women and Children's Health, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China.|Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China.
authors: Lijun
authors: L
authors: Liu
authors: Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China.
authors: Yongbi
authors: Y
authors: Zhou
authors: Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China.
authors: Guiying
authors: G
authors: Wu
authors: Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China.
authors: Fengfei
authors: F
authors: Qin
authors: Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China. hanmin@vip.163.com.|Department of Pediatric Respiratory, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China. hanmin@vip.163.com.
authors: Hanmin
authors: H
authors: Liu
mesh_terms: D016022:Case-Control Studies; D006345:Heart Septal Defects, Ventricular; D006801:Humans; D007223:Infant; D012189:Retrospective Studies; D018497:Ventricular Dysfunction, Right; D016278:Ventricular Function, Right
keywords: Fetuses; Infants; Right ventricular function; Ventricular septal defect