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  • Title: Characterization of ventricular myocardial performance in the fetus by tissue Doppler imaging.
    Author: Watanabe S, Hashimoto I, Saito K, Watanabe K, Hirono K, Uese K, Ichida F, Saito S, Miyawaki T, Niemann P, Sahn DJ.
    Journal: Circ J; 2009 May; 73(5):943-7. PubMed ID: 19276611.
    Abstract:
    BACKGROUND: Clinically useful indices of fetal cardiac function have not been fully delineated for tissue Doppler imaging (TDI). METHODS AND RESULTS: In the present study, 56 pregnancies between the 17(th) and 38(th) weeks of gestation included 38 normal fetuses, 6 cases of hydrops fetalis (HF), and 12 of intrauterine growth retardation (IUGR). Peak velocity in early diastole (E) was measured by pulsed-wave Doppler and the peak annular velocities in systole (Sa) and early diastole (Ea) were measured by TDI. The ratio between flow velocity and annular velocity in early diastole (E/Ea) and the ratio of the Sa of right ventricle to that of the left ventricle (RVSa/LVSa) were estimated. In all fetuses with HF, LVSa was <2 cm/s and LVE/Ea was >13. RVSa/LVSa in the HF group was significantly higher than that in the normal group, and RVSa/LVSa in the IUGR group was significantly lower than that in the normal group. CONCLUSIONS: A combination of low LVSa and high LVE/Ea shows reduced global myocardial performance of the LV, and would be one of the useful indices for quantitative assessment in high-risk pregnancies. Changes in the RVSa/LVSa ratio may reflect afterload changes in both ventricles and compensatory cardiovascular mechanisms occurring during the process of placental insufficiency and heart failure.
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