Impact of selective fetoscopic laser photocoagulation for twin-twin transfusion syndrome on myocardial deformation
10.3760/cma.j.issn.0529-567x.2011.11.013
- VernacularTitle:双胎输血综合征选择性胎儿镜激光凝固手术前后胎儿心肌力学的研究
- Author:
Shi ZENG
;
Qichang ZHOU
;
Rychik JACK
- Publication Type:Journal Article
- Keywords:
Fetofetal transfusion;
Fetoscopy;
Laser coagulation;
Myocardium
- From:
Chinese Journal of Obstetrics and Gynecology
2011;46(11):850-853
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the changes in myocardial deformation in donor and reeipient hearts in response to selective fetoscopic laser photocoagulation (SFLP) for twin-twin transfusion syndrome (TTTS).Methods Totally 25 twin pairs before 24-hour and 1 week after SFLP had fetal echocardiography and digital dynamic two-dimensional four chamber views which were interrogated off-line using velocity vector imaging (VVI) software.Global longitudinal strain (S),systolic strain rate (SRs) and diastolic strain rate (SRd) were measured off-line in the left (LV) and right (RV) ventricles.Results In the donor,SFLP resulted in increase in cardiothoracic ratio ( CTR,0.29 ± 0.03 versus 0.34 ± 0.05,P ＜ 0.01 ),with development of new onset tricupid regurgitation ( n =7 ) and pericardial effusion ( n =5 ) and worsening of all measures of myocardial deformation in both systole and diastole for LV and RV [ LV-S:( - 19.24 ± 3.68 )％ versus (-13.78±3.64)％,P＜0.01; LV-SRs:(-2.28±0.53) versus (-1.43 ±0.41) s-1,P＜ 0.01 ; LV-SRd:( 1.67 ± 0.43 ) versus ( 1.15 ± 0.70) s - 1,P ＜ 0.01 ; RV-S:( - 20.20 ± 3.19) ％ versus (-16.10±3.07)％,P＜0.01; RV-SRs:(-2.03 ±0.65) versus (-1.72±0.38) s-1,P＜0.05; RV-SRd:( 1.71 ±0.30) versus ( 1.50 ±0.36) s-1,P ＜0.05].In the recipient,CTR decreased (0.42 ± 0.04 versus 0.37 ±0.04,P ＜0.01 ) and all parameters for both LV and RV improved substantially [ LV-S:( - 10.62 ± 2.72) ％ versus ( - 16.46 ± 3.23 ) ％,LV-SRs:( - 1.09 ± 0.30) versus ( - 1.60 ± 0.31 ) s-1,LV-SRd:(0.99 ± 0.34) versus (1.53 ± 0.32) s-1,RV-S:( - 11.66 ± 4.56)％ versus ( - 17.96 ± 3.97 ) ％,RV-SRs:( - 1.26 ± 0.39) versus ( - 1.74 ± 0.45 ) s-1,RV-SRd:( 1.15 ± 0.49) versus ( 1.63 ± 0.44 ) s- 1 ; all P ＜ 0.01 ].Conclusion Myocardial deformational mechanics improve in the recipient but worsen in the donor following SFLP for TTTS.
