Effect of hypoxic pulmonary artery hypertension on diastolic function of left ventricular and its correlation with the plasma natriuretic peptide in neonates.

HU Yi-xin; CUI Hua; FENG Zhi-chun

Abstract：Objective To evaluate the effect of pulmonary artery hypertension(PAH) secondary to hypoxia in neonate on the left ventricular diastolic function,and its correlation with plasma natriuretic peptide(BNP).Methods From Nov 2003 to Nov 2008,52 new born infants with hypoxia in PLA General Hospital and Bayi Children's Hospital of Bei-jing Military Area Command General Hospital.were divided into PAH group(34 cases)and control group(18 cases).To compare the index of Doppler echocardiography between the two groups and their correlation with the diastolic function of left ventdcular and the plasma natriuretic peptide.Results (1)Doppler echocardiography showed that the diameter of end diastolic left ventficular,the diameterofright ventricular(RV),andthe pulmonary artery(PA)diameter increased significantly in PAH group compared with those in the control group(P<0.05).The PAH group also had higher velocity of tricuspid valve regurgitation(VTR)and higher pulmonary artery systolic pressure(PASP)than that in the control group(P<0.05).(2)The PAH group also had higher mitral peak A velocity,higher mitral AV velocity time inter(AV-TI),and higher ratio of mitral AV to mitral peak E velocity(EV).The ratio of AVTI/EVTl was significantly increased in PAH group compared with that in the control group.There were no significant change found about LIVRT,EV,EVTI and DT(P<0.05).(3)Compared with the control group.the level of plasma BNP in PAH group was stepped up in the PAH group.(4)In the two groups,there was a positive correlation not only between the PASP and the ratio of mitral AV/ EV(r=0.4126.P<0.01)but also between the value of mitral hemodynamics index and the level of plasma BNP (r=0.4326,P<0.01).Conclusion The PAH second-ary to hypoxia in the newborn infants has led to the diastolic dysfunction and remodeling of left ventricle,and it is important to monitor the plasma BNP in early diagonisis of left ventficular dysfunction in newborn infants with PAH secondary to hypoxia.