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January 1, 2009Circulation JournalOpen Access

Characterization of Ventricular Myocardial Performance in the Fetus by Tissue Doppler Imaging

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Why the study?

Can tissue Doppler imaging indices characterize ventricular myocardial performance in high-risk pregnancies compared to normal fetuses?

Population

56 pregnancies between the 17th and 38th weeks of gestation, including 38 normal fetuses, 6 cases of hydrops…

Comparison

Tissue Doppler imaging and pulsed-wave Doppler… vs Comparison between normal fetuses, fetuses with…

Design

Cross-sectional

Authors

SWSayaka WatanabeSaiseikai Central HospitalIHIkuo HashimotoToyama City HospitalKSKazuyoshi SaitoKyushu International University

Discussion

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Implication

TDI indices may aid fetal myocardial assessment in high-risk pregnancies; hypothesis-generating and requires prospective validation before practice change.

Key Points

  • To delineate clinically useful tissue Doppler imaging parameters for the quantitative assessment of fetal ventricular myocardial performance in normal and high-risk pregnancies.
  • Evaluated 56 pregnancies between 17 and 38 weeks of gestation, comprising 38 normal fetuses, 6 with hydrops fetalis, and 12 with intrauterine growth retardation.
  • Measured peak early diastolic flow velocity via pulsed-wave Doppler alongside peak systolic (Sa) and early diastolic (Ea) annular velocities via tissue Doppler imaging.
  • Calculated the left ventricular early diastolic flow-to-annular velocity ratio (LVE/Ea) and the right-to-left ventricular systolic annular velocity ratio (RVSa/LVSa).
  • All fetuses with hydrops fetalis exhibited left ventricular Sa under 2 cm/s and left ventricular E/Ea greater than 13.
  • The RVSa/LVSa ratio was significantly elevated in fetuses with hydrops fetalis compared to normal controls.
  • Fetuses with intrauterine growth retardation demonstrated a significantly lower RVSa/LVSa ratio relative to the normal group.

Structured PICO

Can tissue Doppler imaging indices characterize ventricular myocardial performance in high-risk pregnancies compared to normal fetuses?

P
Population
56 pregnancies between the 17th and 38th weeks of gestation, including 38 normal fetuses, 6 cases of hydrops fetalis (HF), and 12 of intrauterine growth retardation (IUGR).
I
Intervention
Tissue Doppler imaging (TDI) and pulsed-wave Doppler to measure fetal cardiac function indices
C
Comparator
Comparison between normal fetuses, fetuses with hydrops fetalis, and fetuses with intrauterine growth retardation
O
Outcome
Ventricular myocardial performance indices including LVSa, LVE/Ea, and RVSa/LVSasurrogate

Tissue Doppler imaging indices, specifically low LVSa and high LVE/Ea, can quantitatively assess reduced global myocardial performance in high-risk pregnancies.

Cite This Study

Watanabe et al. (2009) studied this question.

synapsesocial.com/papers/6a702e1d31a3df824328744bhttps://doi.org/10.1253/circj.cj-08-0529
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Tissue Doppler imaging of the fetal heart2000 · 81 citations
  2. 2Doppler Tissue Imaging: A Noninvasive Technique for Evaluation of Left Ventricular Relaxation and Estimation of Filling Pressures1997 · 3,041 citations
  3. 3Fetal tissue Doppler echocardiography: detection rates of cardiac structures and quantitative assessment of the fetal heart2003 · 68 citations
  4. 4Right and left ventricular long‐axis function in the fetus using angular M‐mode2001 · 56 citations
  5. 5Fetal tissue Doppler - a new technique for perinatal cardiology2003 · 16 citations