Myocardial Velocities, Dynamics of the Septum Primum, and Placental Dysfunction in Fetuses with Growth Restriction
| Autor: | Luiz Henrique Soares Nicoloso, Renato Frajndlich, Carolina Weiss Barbisan, Eduardo Becker, Antonio Luis Piccoli, Alexandre Antonio Naujorks, Stefano Boemler Busato, Caroline Cardoso Klein, Mauro Thomé Lopes, Paulo Zielinsky, Patricia Pizzato |
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| Rok vydání: | 2013 |
| Předmět: |
Fetus
medicine.medical_specialty business.industry Diastole Intrauterine growth restriction General Medicine Anatomy Placental insufficiency medicine.disease medicine.anatomical_structure Ventricle Internal medicine Pediatrics Perinatology and Child Health medicine Cardiology Fetal distress Radiology Nuclear Medicine and imaging Surgery Septum primum Interventricular septum Cardiology and Cardiovascular Medicine business |
| Zdroj: | Congenital Heart Disease. 9:138-143 |
| ISSN: | 1747-079X |
| DOI: | 10.1111/chd.12099 |
| Popis: | Introduction Diastolic dysfunction may occur in fetuses with intrauterine growth restriction (IUGR) and may be assessed by myocardial tissue Doppler (MTD). We previously have shown that excursion index of the septum primum (EISP) is reduced in IUGR fetuses over 30 weeks because of a higher left atrial pressure. Patients, Setting, and Design The sample was made up of 14 fetuses with IUGR. MTD examination was carried out with the sample volume placed at the basal lateral wall of the left ventricle (LV), interventricular septum (IVS), and free wall of the right ventricle (RV) to determine E′/A′ ratios. EISP was calculated as the ratio between the maximal excursion of the septum primum into the left atrium during diastole and the maximal diastolic diameter of the left atrium. Mitral and tricuspid flows were assessed by the conventional Doppler method. Outcome Measures Pearson's correlation test was used to analyze the correlations between the parameters. Results A positive correlation was observed between UARI and E′/A′ ratios for RV (r = 0.63, P = .02), IVS (r = 0.59, P = .03), and LV (r = 0.41, P = .15). There was a negative correlation between EISP and IVS E′/A′ ratios (r = −0.58, P = .03), and a positive correlation for LV (r = 0.49, P = .08). At the RV position, a weak negative correlation was observed (r = −0.32, P = .26). Conclusions A higher left atrial pressure in fetuses with IUGR, indicated by the lower mobility of the septum primum, is accompanied by higher ratios between early and late diastolic myocardial velocities. Placental dysfunction was correlated to septal E′/A′ ratios. Fetal MTD can be a useful method to assess severity of placental dysfunction and fetal distress. |
| Databáze: | OpenAIRE |
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