Key result
Higher right ventricular Tei index was significantly associated with perinatal mortality in fetuses with TOF/APV (0.90 ± 0.17 in nonsurvivors vs 0.30 ± 0.28 in survivors, p<0.05).
Why the study?
Does the Tei index correlate with clinical outcome in fetuses with Tetralogy of Fallot with absent pulmonary valve?
Observational (n=8)
Does the Tei index correlate with clinical outcome in fetuses with Tetralogy of Fallot with absent pulmonary valve?
Worse biventricular function assessed by the Tei index, particularly right ventricular function, correlates with high perinatal mortality in fetal TOF/APV.
May support perinatal risk stratification in fetal TOF/APV; leaves open utility pending prospective validation.
Tetralogy of Fallot with absent pulmonary valve (TOF/APV) is a rare form of congenital heart disease with a high risk of perinatal mortality, particularly when diagnosed before birth. We aimed to assess whether global left and right ventricular function in fetal TOF/APV, using the Tei index, correlate with outcome. We reviewed the fetal echocardiogram and clinical outcome of eight fetuses diagnosed with TOF/APV. Of the eight cases, four developed cardiovascular compromise, leading to intrauterine death in two fetuses and neonatal demise in two fetuses, and four fetuses survived the neonatal period. The right ventricular (RV) Tei index was significantly greater and the left ventricular (LV) Tei index tended to be greater in nonsurvivors compared with survivors with TOF/APV (RV Tei, 0.90 +/- 0.17 versus 0.30 +/- 0.28, p < 0.05; LV Tei, 0.97 +/- 0.42 versus 0.54 +/- 0.21). The global LV and RV function can be affected in TOF/APV. Furthermore, more severe pulmonary insufficiency and worse biventricular function as assessed by Tei index likely contribute to the high perinatal mortality associated with this disease.
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Inamura et al. (2005) conducted an observational in Fetal Tetralogy of Fallot with Absent Pulmonary Valve (TOF/APV) (n=8). Right and left ventricular function (Tei index) vs. Survivors was evaluated on Perinatal mortality (p=<0.05). Higher right ventricular Tei index was significantly associated with perinatal mortality in fetuses with TOF/APV (0.90 ± 0.17 in nonsurvivors vs 0.30 ± 0.28 in survivors, p<0.05).
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