Atrioventricular Flow Wave Patterns before and after Birth by Fetal Echocardiography

Abstract

BackgroundDoppler echocardiographic measurements of both valves during intrauterine life can be used to calculate peak early filling velocity (E)/late peak atrial filling velocity (A) ratio as a single index of diastolic performance. The purposes of this study were to estimate the changes in atrioventricular valve flow from gestational age 37-40 weeks to 1 month of postnatal life and to clarify the difference in right and left ventricular diastolic filling patterns.MethodsAtrioventricular flow waves were analyzed in 24 full-term pregnant women by fetal echocardiography. Postnatal follow-up studies were performed at 1 hour, 6 hours, 24 hours, 3 days, 1 week and 1 month. In each time point, pulsed Doppler echocardiography was used to interrogate Doppler waveform of E velocity, A velocity, total area under the curve (time velocity integral) and heart rate.ResultsMitral E/A ratio significantly increased from 0.7 ± 0.1 before birth to 1.0 ± 0.3 at postnatal 1 hour, 1.0 ± 0.2 at 1 week, and 1.5 ± 1.0 at 1 month. Tricuspid flow E/A ratio was 0.8 ± 0.3 before birth, 0.8 ± 0.1 at 1 hour, 0.8 ± 0.2 at 3 days, 0.9 ± 1.0 at 1 month. Time velocity integral of tricuspid flow was significantly higher than that of mitral flow before birth, but there was no difference after birth.ConclusionThe dominance of mitral A wave before birth was changed very quickly after birth to the dominance of E wave, but the dominance of tricuspid A wave was maintained at 1 month. Diastolic function and compliance of mitral valve were better than those of the tricuspid valve after birth.

Impact of ductus arteriosus constriction and restrictive foramen ovale on global hemodynamics for term fetuses with d‐TGA

“…Table 5 compares a wide range of hemodynamic indexes between model simulations and published in vivo measurements for normal term fetuses 30–43 . The simulations show a good overall agreement with in vivo measurements in terms of the CCO, right cardiac output (RCO), left cardiac output (LCO), ventricular end‐diastolic volume (EDV), ventricular ejection fraction (EF), peak systolic velocity (PSV) of the aortic and pulmonary valve, early filling peak velocity (EPV) of the mitral and tricuspid valve, right superior pulmonary vein (RSPV) PSV, AoI PSV, DA PSV, flow ratio of the DV and umbilical vein (UV), and mean arterial pressure of the descending aorta (DAo).…”

Vanillic Acid Alleviates Right Ventricular Function in Rats With MCT-Induced Pulmonary Arterial Hypertension

“…6,33 E/A, calculated as the ratio of peak early filling velocity (E) to late peak atrial filling velocity (A), was used as an indicator of diastolic function. 34,35 The ratio was noticeably lower in the rats from the VA group (Figure 2A, P < .05 vs MCT group, Table 1), indicating a decrease in diastolic function, which can be matched with RVID-Dia.…”