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目的探讨心力衰竭患儿二尖瓣环运动速度的变化及其在左心室功能评价中的应用价值。方法研究对象为2005-01—2006-05在北京大学第一医院儿科住院的21例左室扩大及左室射血分数<50%的心力衰竭患儿(心衰组)和21例正常儿童(对照组),对其行常规超声心动图检查,测量左室射血分数(LVEF)、二尖瓣口前向血流E峰和A峰的峰值流速,计算E/A值;以组织多普勒成像(TDI)脉冲多普勒速度频谱显像方法测量二尖瓣环侧壁及间壁收缩期峰值速度(Sa)、舒张早期峰值速度(Ea)及舒张晚期峰值速度(Aa),分别计算Ea/Aa值及E/Ea值。结果心衰组二尖瓣环侧壁及间壁Sa、Ea、Ea/Aa均显著低于对照组(P均<0.01),两部位E/Ea均显著高于对照组(P均<0.01);心衰组二尖瓣环两部位Sa、侧壁Ea均与LVEF正相关((r=0.60,0.44,0.52,P均<0.05),两部位Sa、Ea均与心功能分级负相关(r=-0.64,-0.55,-0.68,-0.54,P均<0.05),两部位E/Ea均与LVEF负相关(r=-0.59,-0.47,P均<0.05)、与心功能分级正相关(r=0.77,0.75,P均<0.001)、二尖瓣环侧壁及间壁Sa与相应部位Ea、E/Ea有相关性。结论常规超声检查左室收缩功能下降的心力衰竭患儿左室收缩及舒张功能均降低,且二者有密切联系;以TDI方法测定二尖瓣环运动频谱评价心力衰竭儿童左室功能是敏感和可靠的。     

定量组织速度成像和组织追踪显像技术评价先天性甲状腺功能减退症新生儿的右心功能

目的应用定量组织速度成像（QTVI）和组织追踪显像（TTI）技术评价先天性甲状腺功能减退症（CH）新生儿在甲状腺素替代治疗前后的右心功能变化,并探讨其临床应用价值。方法应用QTVI和TTI技术离线分析35例正常新生儿以及52例CH新生儿在左旋甲状腺素（L-T4）替代治疗前与治疗1个月后的心尖四腔切面三尖瓣环运动速度曲线和位移曲线,测量收缩期峰值速度（Vs）、收缩期最大位移（D）、舒张早期峰值速度（Ve）、舒张晚期峰值速度（Va）,计算Ve／Va值;常规记录三尖瓣口脉冲多普勒（PWD）血流频谱,测量舒张早期充盈峰值速度（E）,舒张晚期充盈峰值速度（A）,计算E／A值。同时运用化学发光法检测各组患儿的血清促甲状腺素、三碘甲状腺原氨酸总量、甲状腺素总量、游离三碘甲状腺原氨酸和游离甲状腺素水平,并与QTVI、TTI检测指标行Person相关分析。结果CH组新生儿E峰及E／A值低于对照组（均P〈0．001）,但A峰差异无统计学意义（P〉0．05）;QTVI及TTI示,CH组Ve、Ve／Va值、Vs及D均显著低于对照组,差异有统计学意义（均P〈0．001）,而Va差异无统计学意义（P〉0．05）。经L-T4替代治疗后1个月,CH组新生儿Ve、Ve／Va值、Vs、D及E、E／A值分别为（6．92±1．86）cm／s、（1．13±0．22）、（5．92±1．03）cm／s、（0．78±0．17）cm和（61±10）cm／s、（1．1±0．4）,与治疗前比较差异有统计学意义（均P〈0．001）。相关分析显示,Ve、Ve／Va值、Vs、D与三碘甲状腺原氨酸总量、甲状腺素总量TT4、游离三碘甲状腺原氨酸、游离甲状腺素呈显著正相关（均P〈0．01）,与促甲状腺素呈显著负相关（均P〈0．01）。结论CH新生儿的右心收缩与舒张功能均显著低于正常新生儿,早期及时甲状腺素替代治疗可逆转受损的右心功能。应用QTVI及TTI技术检测三尖瓣环运动频谱可定量、准确、有效地评价新生儿右心功能。     

缺氧性肺动脉高压新生儿右心室功能的组织速度多普勒超声研究

目的 探讨组织速度多普勒成像(TVI)技术评价缺氧性肺动脉高压(HPH)新生儿右心室功能的价值.方法 35例HPH患儿及28例正常新生儿于生后3 d应用超声心动图测量肺动脉收缩压(PASP),用传统超声技术测定右室射血分数(RVEF)值、右心室舒张早期峰值(E峰)、舒张晚期峰值(A峰)、E/A值,同时以TVI技术测量三尖瓣环指标(收缩期波Sa、舒张早期波Ea、舒张晚期波Aa、Ea/Aa值).结果 HPH组三尖瓣环Sa、Ea、Ea/Aa及RVEF值较对照组减低(t=2.67～4.69,P均<0.01).HPH组的右心室E/A值较对照组减低,但差异无统计学意义.HPH组的三尖瓣环Sa与RVEF值呈正相关(r=0.451,P<0.05).结论 HPH新生儿的右心室舒张、收缩功能减低,TVI技术与传统超声技术结合能更敏感地发现右心室功能变化.     

多普勒组织速度成像法在评价室间隔缺损左心功能中的作用

目的　评估多普勒组织速度成像法 (TVI)对室间隔缺损 (VSD)患儿左心功能评价的临床应用。方法　根据VSD直径 /主动脉直径比值将 87例VSD患儿分为小型室间隔缺损 (VSDS)组、中型窒间隔缺损 (VSDM)组及大型室间隔缺损 (VSDL)组。运用TVI和M型超声及脉冲多普勒 (PWD)分别测定VSD二尖瓣环收缩期运动速度 (s)、二尖瓣环舒张早期运动速度 (e)和二尖瓣环舒张晚期运动速度 (a) ,左室射血分数 (LVEF)及二尖瓣血流频谱E峰和A峰 ,并与正常儿童对照。结果　 1.3组s、LVEF、E与正常对照组比较无明显差异 (P均 >0 .0 5)。 2 .VSDL 组e(6.66± 2 .2 5cm/s)、e/a (1.0 1± 0 .52 )明显较正常对照组 (7.96± 1.57cm/s)、(1.85± 0 .52 )低 (P均 <0 .0 5) ;而a(7.2 9± 2 .6cm/s)明显较正常对照组 (4.57± 1.3 8cm/s)高 (P <0 .0 1) ;VSDS、VSDM 组e、a、e/a与正常对照组比较无明显差异 (P >均 0 .0 5)。 3 .VSDL 组A(0 .83± 0 .2 4m/s)明显比正常对照组 (0 .66± 0 .16m/s)高 (P <0 .0 1) ;而E/A(1.0 1± 0 .52 )明显比正常对照组 (1.69± 0 .3 6)低 (P <0 .0 5) ;VSDS、VSDM 组E、A、E/A与正常对照组比较无明显差异 (P均 >0 .0 5)。结论　 1.各型VSD左心室收缩功能和小、中型VSD左心室舒张功能在婴幼儿期无明显改变。VS     

小儿心内膜弹力纤维增生症心率变异改变及其与心脏结构功能的相关性研究

目的 研究心内膜弹力纤维增生症(EFE)患儿的心率变异(HRV)改变及其与心脏结构和功能的相关性.方法 对山东省立医院儿科30例EFE患儿和20例健康儿童分别进行24h心率变异分析,得出SDNN、SDANN、PNN50、rMSSD、LF、HF及LF/HF等指标.行常规超声心动图检查,取得左房舒张未期前后径(LAED)、左室舒张末期前后径(LVED)、室间隔舒张末期厚度(IVSTd)、心脏指数(CI)、左室射血分数(LVEF)、短轴缩短率(LVFS)、二尖辩舒张早期血流速度峰值(E)、舒张晚期血流速度峰值(A)、峰值速度比值(E/A)及左房射血力(LAF)等指标.对两组的上述指标进行比较,并分析心内膜弹力纤维增生症患儿的心率变异性与心脏结构和功能的相关性.结果 与对照组相比,EFE组的LAED和LVED明显增大,IVSTd明显增厚,CI、LVEF、LVFS、二尖瓣E峰均显著降低,LAF明显增大,二尖辩A峰及E/A变化不明显;心率变异指标中SDNN、PNN50、rMSSD、LF、HF均明显降低,LF/HF升高,SDANN无明显改变;SDNN与LVEF、LVFS强相关,与CI、LAF、LVED、IVSTd中等相关,IF/HF与LAF中等相关,其余HRV指标与心脏的结构和心功能的指标间无明显的相关性.结论 EFE患儿存在HRV的异常改变,表现为植物神经的普遍受损,HRV中部分指标的改变与房室腔扩大、心内膜增厚和心功能下降有一定的相关性,部分HRV指标是相对独立的,将HRV指标与超声指标结合起来能更好的指导临床.     

定量组织多普勒成像技术评价白血病患儿化疗前后左心室功能的临床研究

目的 探讨定量组织多普勒速度成像技术（QTVI）对白血病患儿化疗前后左心整体及局部功能变化的诊断价值。方法 将16例急性白血病患儿按照化疗剂量分为两组：Ⅰ组化疗药物累积剂量为120～180mg／m2，Ⅱ组为240360mg／m^2。另设22例正常儿为对照组。用常规检测超声心动图Simpson法测量左心整体收缩功能，用频谱多普勒检测左心整体舒张功能，用QTVI分别测量心脏瓣环及各室壁节段的局部收缩和舒张功能，对比研究QTVI技术和常规超声心功检测法对白血病化疗的心脏毒性的检测效果。结果 化疗前Ⅰ、Ⅱ组与正常儿比较各参数差异无显著性（P〈0．05）。Simw,on法未发现Ⅰ、Ⅱ组收缩功能异常；QTVI发现侧壁的VS环较化疗前减低，且有6个节段的VS段有不同程度的下降。在舒张功能的检测方面，频谱多普勒仅于Ⅱ组检出二尖瓣E峰较化疗前降低；而QTVI发现Ⅰ组后间隔、下壁瓣环水平与Ⅱ组六个瓣环水平（包括VE环的均值）较对照组显著降低。结论 QTVI能定量评价左室收缩、舒张期的整体及局部心功能，优于常规超声检测法，并能动态观察急性白血病患儿化疗前后及不同累积剂量对左心功能的影响，为临床提供一种敏感、准确的心脏功能检测新方法。     

肺炎心衰时脑钠素改变及其与心功能关系的临床与实验研究

目的 探讨重症肺炎时血清脑钠素(BNP)的变化及其与心脏收缩功能的关系。方法 对2002年8月至2004年4月在山东省立医院确诊的70例肺炎患儿及20例正常健康儿行超声心动图检查,同时将50只大鼠制成肺炎大鼠30只和正常大鼠20只,也行上述检查;采用酶联免疫吸附法检测上述各组BNP水平。结果 肺炎心衰组患儿及左室射血分数(LVEF)下降大鼠组血清BNP水平显著高于健康对照组及正常大鼠对照组,且与LVEF、左室短轴缩短率(LVFS)呈负相关(P<0.05);肺炎心衰组患儿与健康组患儿比较,LVEF下降大鼠与正常大鼠比较,主动脉血流峰值流速(PFVA)、肺动脉血流峰值流速(PFVP)、主动脉血流速度积分(Viao)、肺动脉血流速度积分(Vipa)、LVEF、LVFS显著减少(P<0.05)。结论 严重肺炎可引起心衰,血清BNP测定可作为诊断心功能不全的生化指标。     

组织多普勒成像对正常儿童房室环运动的研究

目的探讨组织多普勒成像(TDI)技术定量评价儿童心室功能的应用价值,研究儿童体格及心脏的生长发育对TDI参数的影响。方法用TDI方法测量242例出生后3d至17岁正常健康儿童二尖瓣环侧壁、间壁及三尖瓣环侧壁收缩期峰值速度(Sa)、舒张早期峰值速度(Ea)及舒张晚期峰值速度(Aa),并与临床资料及常规超声心动图指标进行对比研究。结果(1)各取样点Sa、Ea均以<1个月组最低[二尖瓣环侧壁:Sa(4.8±0.7)cm/s,Ea(6.6±1.1)cm/s,间壁:Sa(4.1±0.6)cm/s,Ea(5.0±0.8)cm/s;三尖瓣环Sa(6.2±1.2)cm/s,Ea(6.4±1.0)cm/s],并随年龄增长逐渐增长,1个月～组至1岁～组显著增长[1岁～组二尖瓣环侧壁:Sa(8.5±2.0)cm/s,Ea(16.3±2.6)cm/s,间壁:Sa(7.2±0.8)cm/s,Ea(12.2±1.6)cm/s;三尖瓣环:Sa(12.6±2.3)cm/s,Ea(14.7±2.6)cm/s],1岁～组三尖瓣环Sa、Ea较二尖瓣环更接近年长儿相应测值。二尖瓣环E/Ea值<1个月至7个月～组较高(侧壁9.2±2.1,间壁12.10±2.89),随年龄增长逐渐降低,1岁～组显著降低(侧壁5.9±1.2,间壁7.8±1.3)。(2)年龄、体表面积、心率及左心室舒张末期内径(LVEDD)对多数TDI参数有显著影响。LVEDD是影响二尖瓣环Sa、Ea的主要因素,是二尖瓣环E/Ea值的独立影响因子。结论正常儿童左、右心室收缩及舒张功能随年龄增长逐渐发育,这一发育过程以婴幼儿期最为快速,右心室功能的发育早于左心室,儿童体格及心脏的正常发育对心室收缩及舒张功能的发育有重要影响,LVEDD是左心室收缩及舒张功能的重要影响因素。     

组织多普勒成像对早期新生儿心室功能的评价

目的 应用组织多普勒成像（TDI）检测新生儿房室环运动，探讨不同胎龄早期新生儿左右心室功能的特点。方法 采用TDI技术检测生后3—7d的36例胎龄32～36周早产儿（早产儿组）和33例足月新生儿（足月儿组）二、三尖瓣环运动，测量收缩期峰值速度（Sa）、舒张早期峰值速度（Ea）及舒张晚期峰值速度（Aa），以脉冲多普勒显像测量舒张期二、三尖瓣口血流E峰及A峰峰值速度。结果 早产儿组各部位Ea、Sa均显著低于足月儿组，早产儿组三尖瓣环Ea／Aa显著低于足月儿组，两组Aa及E／Ea无显著差异；各部位Ea、Sa与胎龄及出生体质量均呈正相关。结论 早产儿左、右室收缩及舒张功能均低于足月儿，早期新生儿心室功能与其出生前成熟程度有关，早产儿及足月新生儿生后早期左室舒张功能均明显增强。     

蒽环类药物心脏毒性早期监测方法的评价

目的：蒽环类药物（ANT）对白血病、实体瘤疗效显著,但因其心脏毒性,严重影响患儿远期生活质量。本研究旨在评价二维超声（2DE）和血清生化指标早期监测ANT心脏毒性的价值。方法：70例接受ANT化疗患儿（ANT剂量124±73 mg/m2,随访22±13月）进行2DE检测,包括常规指标（左室内径及室壁厚度、射血分数、E/A等）、心肌工作指数（MPI）、组织多普勒（TDI）, 并采血检测血清肌钙蛋白(CTnI)、脑利钠肽(BNP)含量。37例健康体检儿为对照组。结果：病例组2DE常规指标与对照组比较差异无统计学意义。与对照组比较,病例组左、右室MPI明显增大（0.237±0.06、0.171±0.05 vs 0.203±0.06、0.140±0.04,P<0.01）,TDI示病例组左室侧基底段、中间段舒张晚期组织运动峰值速度（Am）,室间隔侧基底段、中间段Am,右室侧基底段、中间段Am均较对照组明显增高;左室侧中间段舒张早期组织运动峰值速度（Em）/Am,室间隔侧基底段、中间段Em/Am差异有统计学意义（P<0.05）。且随着ANT累积剂量增加,MPI和TDI变化更加明显。血清CTnI、BNP水平与对照组比较差异无统计学意义。结论：接受ANT治疗者需长期监测心功能;MPI、TDI能早期反映ANT对患者心功能的影响。     

Efficiency of left ventricular diastolic function increases in healthy full-term infants during the first months of life. A prospective follow-up study

Postnatal changes in left ventricular diastolic filling and systolic cardiac performance were studied monthly by serial echocardiographic measurements from days 3-5 up to six months in 20 healthy full-term infants. The fractional shortening area (FSA = (left ventricular end-diastolic area - end-systolic area)/end-diastolic area) was assessed for systolic performance, and transmitral pulsed-wave Doppler flow velocity patterns were analysed for diastolic function. FSA remained stationary during the observation. After birth, left ventricular peak early (E) and atrial (A) velocities and the respective integrals were lower than at one month of age (47+/-5 vs. 63+/-6 cm/s and 44+/-6 vs. 57+/-5 cm/s and 3.33+/-0.40 vs. 4.05+/-0.53 cm and 2.74+/-0.40 vs. 3.18+/-0.53 cm; P < 0.05). During the next five months, the early parameters (E velocity and E integral) increased but the atrial indices (A velocity and A integral) did not change. During the whole observation the E/A velocity ratio, the E/A integral ratio and the early filling fraction (EFF) increased. The early filling deceleration time was longer during the first month than later (87+/-10 vs. 72+/-13 ms; P < 0.05). In conclusion, age-related changes were observed in the diastolic but not in the systolic performance in healthy full-term infants during the first six months. The most intensive changes took place in the early and atrial transmitral parameters during the first month of life, suggesting an improvement in both left ventricular relaxation and compliance. During the following five months, the early mitral parameters increased but the atrial diastolic values remained stable. These changes may mainly be determined by the improvement in left ventricular relaxation.     

Effects of levothyroxine therapy on left and right ventricular function in neonates with congenital hypothyroidism: a tissue Doppler echocardiography study

Cardiac function is impaired in adults or children with hypothyroidism and it can be reversed by levothyroxine (L-T₄) substitution therapy. However, only a few studies are available on left and right ventricular function in neonates with congenital hypothyroidism (CH), most of which were performed with standard echocardiography. The aim of this study was to investigate the effects of L-T₄ substitution therapy on left and right ventricular function in neonates with CH, measured with tissue Doppler echocardiography (TDE) and conventional echocardiography. Fifty neonates (27 females and 23 males) with CH and 35 normal neonates (19 females and 16 males) underwent conventional echocardiography and TDE. On TDE, peak mitral and tricuspid annular systolic (Sa) velocity, peak early (Ea) and late (Aa) mitral and tricuspid annular diastolic velocity were measured, and the Ea/Aa ratio was calculated. All the biochemical tests and echocardiographic evaluations were reevaluated after 1 month of replacement therapy. In CH neonates, TDE showed that CH neonates had significantly lower Sa, Ea, and Ea/Aa of both left and right ventricles (P < 0.001, respectively). However, Aa of left and right ventricles did not differ significantly. After 1 month of substitutive therapy, CH neonates showed a significant increase of Sa and Ea and a subsequent increase of the Ea/Aa ratio (P < 0.001, respectively). Our findings suggest that neonates with CH suffer from right ventricular subclinical systolic and diastolic dysfunction in addition to left ventricular dysfunction. Early L-T₄ substitution therapy is able to reverse the impairment of cardiac function.     

多普勒超声心动图对先天性心脏病合并肺动脉高压儿童左室形态与功能的评价

目的：探讨多普勒超声心动图对先天性心脏病（CHD）儿童肺动脉高压（PAH）的诊断价值及PAH对左室重塑和舒张功能（LVDF）的影响。方法：对彩色多普勒超声心动图证实的45例继发肺动脉高压的先天性心脏病患儿的超声心动图和多普勒血流资料与22例无PAH的先天性心脏病患儿（对照组）对比分析。结果：PAH组及对照组的左室舒张末内径分别为18.24±1.71 mm vs 16.28±0.52 mm、右室内径 12.23±2.14 mm vs 8.14±0.73 mm、肺动脉内径 11.20±1.35 mm vs 7.92±0.21 mm。两组比较差异有显著性（P<0.05）；VTR 流速增快（2.56±0.46）m/s及PASP压力（40.23±4.56）mmHg升高 ，与对照组相比差异亦有显著性（P<0.05）；室间隔增厚与对照组相比差异不明显。对照组、PAH组的二尖瓣口血流多普勒频谱A峰流速分别为94.56±31.45 m/s vs 51.17±26.67 m/s、A峰流速速度时间积分为10.89±2.73 s vs 4.94±1.85 s及AV/EV为1.79±0.32 vs 0.59±0.19、AVTI/EVTI为1.61±0.49 vs 0.45±0.21 两组比较差异有显著性(P<0.01)。左室等容舒张时间分别为119. 86±54.62 s vs 52.31±28.06 s。PAH组明显延长(P<0.05)。E峰流速、E峰流速速度时间积分及E峰减速时间两组无明显改变(P>0.05)。而增高的肺动脉压与二尖瓣口血流频谱AV/EV比值呈正相关,相关系数 r=0.4 456， P<0.01。结论：多普勒超声心动图不仅是先天性心脏病儿童合并肺动脉高压最重要的诊断方法之一，还可提供肺动脉高压对左室重塑和舒张功能受损的指标，对临床判断病情轻重及预后有重要价值。［中国当代儿科杂志，2007，9（5）：422-424］     

Body Mass Index Can Predict Left Ventricular Diastolic Filling in Asymptomatic Obese Children

To examine the effects of body mass index on left ventricular diastolic function, flow velocity patterns of the pulmonary vein and mitral valve were measured by pulse Doppler echocardiography in 21 asymptomatic obese children and were compared with those of an age-matched control population. The degree of obesity was calculated as (actual body mass index/ideal body mass index -1) x 100. The pulmonary venous flow indexes were peak systolic (S) and diastolic (D) velocities and peak D/S. The mitral inflow indexes were peak velocities of early diastole (E) and atrial contraction (A) and peak E/A. The pulmonary venous flow velocity pattern in obese patients was characterized by unchanged peak S, decreases in peak D (43 +/- 7 vs 51 +/- 8, p < 0.01) and peak D/S (0.98 +/- 0.19 vs 1.29 +/- 0.20, p < 0.01), suggesting the reduction in the early diastolic filling. The peak D/S decreased significantly with an increase in the percentage body mass index (r = -0.84, p < 0.01). In contrast to the pulmonary venous flow pattern (peak D > peak S) as seen in normal controls, all of the obese patients with > 70% over body mass index had abnormal pulmonary venous flow velocity patterns (peak D < peak S). The mitral flow velocity pattern in obese patients was also characterized by a decrease in early diastolic filling. However, these indices did not correlate with an increase in the percentage over body mass index. This study suggests that body mass index predicts the abnormality of left ventricular diastolic filling assessed by pulmonary venous flow patterns.     

原发性高血压儿童血尿酸水平与心脏亚临床损伤的相关性

目的 评估原发性高血压儿童的心脏亚临床损害情况,并分析血尿酸水平与心脏亚临床损害的相关性.方法 回顾性分析2015年1月至2020年6月于苏州大学附属儿童医院心血管内科住院的55例原发性高血压患儿治疗前的临床资料,并选取该院同期同年龄、同性别的45例健康体检儿童作为对照组.分析两组儿童临床特征、实验室检查、左心结构、收...     

扩张型心肌病的心功能变化:多普勒组织显像的敏感性与可靠性

探讨扩张型心肌病（DCM）的心功能变化,比较多普勒组织显像（DTI）与传统心功能指标的敏感性及可靠性。方法对25例DCM患儿分别测量其心腔大小、EPSS（Epoint－septalseparation）、左室心肌重量指数（LVMI）、二大瓣血流E峰及A峰、左室射血分数（LVEF）、每搏指数（SI）及DTI测量其二尖瓣环收缩期及舒张早期运动速度（MVR－SV、MVR－DeV）,在室后壁心内膜收缩期及舒张期运动速度（LVPW－EnSV、LVPW－EnDV）,并设正常对照组143名。结果DCM患儿心脏收缩及舒张功能均显著下降,心肌运动速度显著降低．MVR－DeV与LVMI、EPSS是显著负相关（r=-0．84,-0．83P＜0．01）,与LVEF、SI是显著正相关（r=0．844,0．77P＜0．01）,同时其敏感性显著高于LVEF及SI（P＜0．05）;DTI测量心肌的舒张功能其敏感性、可靠性均高于二失瓣血流E峰与A峰,而E／A敏感性最差,且多数DCM呈假性正常,MVR－DeV与E峰、A峰及E／A均无显著直线相关性（P均＞0．05）,与病情一致。结论DCM的收缩及舒张功能均显著下降,DTI指标较传统心功能指标更敏感而可靠。     

Serial echocardiographic and Doppler evaluation of left ventricular systolic performance and diastolic filling in premature infants

To examine the effects of somatic growth on left ventricular systolic and diastolic functions in premature infants, we performed serial two-dimensional, M-mode and Doppler echocardiograms of 18 premature infants in the early neonatal period (mean of 14 days) and on the day when they were discharged from the hospital (mean of 94 days). The relation between rate-corrected mean velocity of fiber shortening and end-systolic wall stress relation was used as a load-independent estimate of contractility. Diastolic function was assessed by transmitral Doppler filling velocity patterns. The end-systolic wall stress was significantly lower in the first examination than in the second examination (38+/-8 vs. 46+/-10 g/cm2, P < 0.005). However, there was no significant difference in the rate-corrected velocity of fiber shortening between the two examinations. An inverse linear relation between the end-systolic wall stress and the rate-corrected mean velocity of fiber shortening was found in each examination. The slopes of these two regression lines showed no significant difference, suggesting that the left ventricular contractility is on the same level during this study period. The transmitral Doppler flow velocity patterns markedly altered between the two observations. The peak E wave, peak A wave, peak E/A ratio, flow velocity time integral of E/A wave, the first third filling fraction, and the normalized peak filling rate to stroke volume increased significantly during the study period (78+/-14 vs. 31+/-9 cm/s, 61+/-12 vs. 33+/-7 cm/s, 1.29+/-0.18 vs. 0.93+/-0.19, 1.75+/-0.58 vs. 1.17+/-0.24, 0.42+/-0.07 vs. 0.37+/-0.05, and 9.48+/-1.71 vs. 7.30+/-0.96/s, respectively, P < 0.001), suggesting a relative shift of Doppler filling into the early diastole. We demonstrated that the age- and growth-related alterations in the transmitral Doppler filling patterns occurred dramatically without changes in contractility during the first 3 months after birth. This diastolic filling change may be related to the age-related maturation in the left ventricular diastolic properties.