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

Sayaka Watanabe; Ikuo Hashimoto; Kazuyoshi Saito; Kazuhiro Watanabe; Keiichi Hirono; Keiichiro Uese; Fukiko Ichida; Shigeru Saito; Toshio Miyawaki; Petra Niemann; David J Sahn

doi:10.1253/circj.CJ-08-0529

Pediatric Cardiology

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

Sayaka Watanabe, Ikuo Hashimoto, Kazuyoshi Saito, Kazuhiro Watanabe, Keiichi Hirono, Keiichiro Uese, Fukiko Ichida, Shigeru Saito, Toshio Miyawaki, Petra Niemann, David J Sahn

Author information

Sayaka Watanabe
Department of Pediatrics, School of Medicine, University of Toyama
Ikuo Hashimoto
Department of Pediatrics, School of Medicine, University of Toyama
Kazuyoshi Saito
Department of Pediatrics, School of Medicine, University of Toyama
Kazuhiro Watanabe
Department of Pediatrics, School of Medicine, University of Toyama
Keiichi Hirono
Department of Pediatrics, School of Medicine, University of Toyama
Keiichiro Uese
Department of Pediatrics, School of Medicine, University of Toyama
Fukiko Ichida
Department of Pediatrics, School of Medicine, University of Toyama
Shigeru Saito
Department of Obstetrics and Gynecology, School of Medicine, University of Toyama
Toshio Miyawaki
Department of Pediatrics, School of Medicine, University of Toyama
Petra Niemann
Clinical Care Center for Congenital Heart Disease, Oregon Health and Science University
David J Sahn
Clinical Care Center for Congenital Heart Disease, Oregon Health and Science University

Keywords: Fetal cardiac function, Hydrops fetalis, Intrauterine growth retardation, Peak annular velocity, Tissue Doppler imaging

JOURNAL FREE ACCESS

2009 Volume 73 Issue 5 Pages 943-947

DOI https://doi.org/10.1253/circj.CJ-08-0529

View "Advance Publication" version (March 11, 2009).

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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. (Circ J 2009; 73: 943 - 947)

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