J Korean Pediatr Soc.
1994 May;37(5):596-605.
Evaluation of Pulmonary Venous, Mitral and Aortic Flow Pattern by Doppler Echocardiography in Neonates
Abstract
- Pulmonary vein velocities have recently been estimated in conjunction with mitral flow velocities to increase our understanding o 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 occured consistently before aortic valve closure. 2) The peak velocities of early systolic, late systolic, late systolic, diastolic and atrial systolic in the pulmonary venous flow were 36.4 (13.2cm/sec, 45.3 (15.3cm/sec, 48.5 (14.1cm/sec and 16.6( 5.7cm/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( 0.3 at 1 day o1, 1.1( 0.4 at 1 week old and 1.2 (0.3 at 1 month old. The difference between old and 1 month old was statistically significant(p<0.05). 4) The peak early diastolic velocity of mitral flow was 51.3 (15.2cm/sec at 1 day old, 54.7( 13.7cm/sec at 1 week old and 80.7 (16.6cm/sec at 1 month old. The difference between 1 week old and 1month old was statistically significant(p<0.01). 5) The peak late diastolic velocity of mitral flow was 48.3 (14.6cm/sec at 1 day old, 50.1( 9.9cm/sec at 1 week old and 71.8 (16.6cm/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( 0.2 at 1 day old, 1.1( 0.3 at 1 week old and 1.2( 0.7at 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 (14.2cm/sec at 1 day old, 67.8 13.4cm/sec at 1 week old and 76.6 14.1cm/sec at 1 month old. The difference between 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.