Changes in pulmonary venous flow pattern during early neonatal life.

Agata, Y; Hiraishi, Satoshi; Oguchi, Kouki; Nowatari, Masahiko; Hiura, K.; Yashiro, Kimio; Shimoda, Terufumi

doi:10.1136/hrt.71.2.182

Cited by 21 publications

(13 citation statements)

References 20 publications

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“…The Doppler study showed an almost continuous flow between the systolic and diastolic deflections of the pulmonary flow in G1 patients, probably due to the presence of anterograde flow during the entire cardiac cycle resulting from the increased pulmonary flow. This was previously reported by Agata et al 8 in a study with pulsed Doppler in newborn infants. Those authors observed in the first hour of life an almost continuous pulmonary venous flow of higher velocity, similar to that obtained in situations of congenital obstruction of the pulmonary veins, and compared it with the flow obtained 24 hours later, which was intermittent and with a lower velocity, similar to the flow in adults.…”

Section: Discussionsupporting

confidence: 80%

Echocardiographic Assessment of the Pulmonary Venous Flow: An Indicator of Increased Pulmonary Flow in Congenital Cardiac Malformations

Rivera¹,

Moisés²,

Paola³

et al. 2002

Arq. Bras. Cardiol.

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Echocardiography is currently the method of choice to diagnose congenital cardiac malformations. The 2-dimensional analysis allows both an accurate determination of the defect and identification of the hemodynamic repercussion, ie, hypertrophy or dilation of the cardiac chambers due to the pathophysiological mechanism of the malformation. In the malformations that increase pulmonary flow, we observe dilation of the recipient chambers, either the left ones in posttricuspid malformations, or the right ones in pretricuspid malformations 1 . Doppler assessment of the pulmonary venous flow (return flow of the increased pulmonary flow) has not been used as a parameter to indicate the presence of the defect.Several studies [2][3][4][5] have been carried out, initially in adults and later in children, assessing the pulmonary venous flow in the right superior pulmonary vein because of the easy obtainment of that flow. We have observed that, in conditions of increased pulmonary flow, the left inferior pulmonary vein is extremely dilated, and this could be used as an indirect parameter to assess the presence of cardiac malformations leading to increased pulmonary flow.The objective of our study was to identify the left inferior pulmonary venous flow in conditions of increased pulmonary flow and to compare these findings with those obtained in healthy children or in children with a cardiac malformation of the normal or decreased pulmonary flow type. MethodsWe consecutively and prospectively studied 40 patients divided into 2 groups as follows: (G1 -group 1) 20 patients with congenital cardiac malformation with increased pulmonary flow, and (G2 -the control group) 20 patients with normal intracardiac anatomy or with other types of malformations (tab I). The patients were not paired by sex or age. The conventional transthoracic echocardiographic study was performed with commercially available equipment (Apogee CX, ATL) and 2.5-and 5.0-MHz transducers

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Section: Discussionsupporting

confidence: 80%

Echocardiographic Assessment of the Pulmonary Venous Flow: An Indicator of Increased Pulmonary Flow in Congenital Cardiac Malformations

Rivera¹,

Moisés²,

Paola³

et al. 2002

Arq. Bras. Cardiol.

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“…The pulmonary venous flow wave pattern of this kind is not established immediately after birth. Agata et al [19] reported on pulmonary venous flow wave patterns in early neonates and showed that the flow was continuous with a very high velocity. The velocity at atrial contraction was also forward toward the left atrium.…”

Section: Discussionmentioning

confidence: 99%

Doppler Study on Pulmonary Venous Flow in the Human Fetus

Hong

Choi

1999

Fetal Diagn Ther

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Objectives: The fetal pulmonary circulation is different from the postnatal circulation: the flow is small. The arterial pressure is almost systemic, and the vascular resistance is high. Moreover, lungs are collapsed in the fetus. However, the pulmonary venous flow in the fetus has not been studied. The aims of this study were to look at flow patterns of pulmonary venous system in the fetus and to see whether there are any changes in Doppler parameters with fetal growth. Methods: The pulmonary venous flow velocity was analyzed in 56 normal human fetuses. The fetal gestational age ranged from 17 to 37 weeks. Pulsed-Doppler echocardiography was used to investigate the right upper pulmonary vein in four-chamber view. After the pulmonary venous signal was obtained, by enlarging the sample size, the pulmonary arterial signal was superimposed for timing. Heart rate velocities at systolic peak (S), at diastolic peak (D), at nadir between S and D (O), and at nadir between D and the next S (X) and velocity-time integral were measured. Results: The pulmonary venous signal showed basically continuous flow from pulmonary vein toward left atrium through all the cardiac cycles, and it had biphasic peaks: one during the systolic and the other during the diastolic phase. The systolic peak of pulmonary vein occurred slightly earlier or later than the systolic upstroke of pulmonary arterial waveforms. The systolic peak of pulmonary vein was higher than the diastolic peak in 45 out of 56 cases. Velocities of systolic and diastolic peaks and velocity-time integral of the pulmonary vein have significantly increased with fetal growth. Conclusions: In the fetus, the flow pattern of the pulmonary vein was similar to that of the postnatal pattern with the exception of absence of atrial reversal. Lower velocities may reflect a decreased pulmonary flow volume.

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“…A decrease in pulmonary venous flow occurs immediately after birth, 29 and reflects a sudden increase in pulmonary circulatory volume with additional left to right shunting through the PDA. Also, E/Vp decreases with closure of the PDA.…”

Section: Discussionmentioning

confidence: 99%

Left Ventricular Diastolic Performance in Neonates

Iwashima

Seguchi

Ohzeki

2005

Circ J

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Echocardiographic EvaluationEchocardiography measurement was performed while the infants were resting. A complete 2-dimensional echocardiographic examination was performed using a HewlettPackard Sonos 2000 with a 5.0 MHz transducer. We mea- Left Ventricular Diastolic Performance in NeonatesSatoru Iwashima, MD; Masashi Seguchi, MD*; Takehiko Ohzeki, MD Background The left ventricular (LV) diastolic performance of infants who were in a stable post-treatment condition in the neonatal intensive care unit was evaluated using echocardiography. Methods and ResultsThe study group comprised 55 infants (Stable infant group, SI) and the parameters of LV performance were: LV propagation velocity (Vp) by color M-mode Doppler echocardiography (CMD), peak E wave, peak A wave, and the E/A ratio of transmitral flow. In a second set of measurements, a subset of 10 infants (patent ductus arteriosus (PDA) infant group, PI) were evaluated for LV diastolic performance during closure of PDA. The mean Vp in the SI was 27.2±7.3 cm/s and a positive correlation was observed between Vp and gestational age (r=0.477, p=0.0002). In the PI, Vp did not change significantly during closure of the PDA (from 23.3±8.2 cm/s to 27.5±8.4 cm/s); however, the E/Vp ratio decreased significantly with closure (from 3.14±0.83 to 2.12±0.68, p=0.0051). Conclusion The measurement of Vp by CMD can be considered a parameter for the evaluation of LV diastolic performance, even in the neonatal period. The LV diastolic performance of the infant is maintained from immediately after birth to spontaneous closure of the PDA. (Circ J 2005; 69: 1094 -1098

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Changes in pulmonary venous flow pattern during early neonatal life.

Cited by 21 publications

References 20 publications

Echocardiographic Assessment of the Pulmonary Venous Flow: An Indicator of Increased Pulmonary Flow in Congenital Cardiac Malformations

Echocardiographic Assessment of the Pulmonary Venous Flow: An Indicator of Increased Pulmonary Flow in Congenital Cardiac Malformations

Doppler Study on Pulmonary Venous Flow in the Human Fetus

Left Ventricular Diastolic Performance in Neonates

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