Beat‐to‐beat variability of fetal myocardial performance index

Maheshwari, P.; Alphonse, Jennifer; Henry, Amanda; Wang, J.; Redmond, Stephen J.; Welsh, Alec

doi:10.1002/uog.16012

Cited by 6 publications

(9 citation statements)

References 22 publications

(26 reference statements)

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“…It may be that averaging more beats may reduce this variability, as has been suggested in previous reports. 19 As this is the first report assessing test-retest agreement of fetal Doppler velocimetry profiles, additional studies should be performed to confirm these findings. The current study is somewhat limited by a smaller sample size, though statistical analysis would suggest that it is sufficiently precise to allow one to draw important conclusions from the data.…”

Section: Discussionmentioning

confidence: 67%

“…It is not unexpected that VTI and PI measurements that require tracing of, sometimes complex, spectral Doppler patterns would have lower agreement. It may be that averaging more beats may reduce this variability, as has been suggested in previous reports 19. As one would expect, those assessments requiring the use of more than one quantitative measure, such as MPI or cardiac output, had the worst agreement in all three methods given the compounding of measurement error, with >20% percent difference on test-retest assessment.…”

mentioning

confidence: 60%

“…5,[16][17][18] We utilize the valve click method for MPI assessment, as it has previously been reported to lower variation. 5 Recent reports would suggest that there is significant beat-to-beat variability in assessment of MPI in the fetus, 19 and this may have impacted our findings, even though it is our practice to measure MPI over three beats and average. It may be that averaging more beats may reduce this variability, as has been suggested in previous reports.…”

Section: Discussionmentioning

confidence: 97%

“…In comparison, the intra-observer percent mean difference and inter-observer percent mean difference were all <10% (with the exception of pulmonary vein VTI). 5 Recent reports would suggest that there is significant beat-to-beat variability in assessment of MPI in the fetus,19 and this may have impacted our findings, even though it is our practice to measure MPI over three beats and average. However, this limited agreement is clearly more noticeable when two separate acquisitions are obtained and separately measured than when the same acquisition is measured twice.2-dimensional and M-mode measurements were in the middle witha fair agreement on test-retest assessment.…”

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confidence: 95%

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Test–retest variability for quantitative two‐dimensional and Doppler measurements in the fetus

et al. 2018

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Objectives: Echocardiography is used to quantitatively characterize cardiovascular function in fetuses with cardiac abnormalities and inform decisions for fetal or perinatal interventions. It is clinically important to understand the reproducibility of these measures, particularly between testers. While studies have reported intraobserver variability and inter-observer variability, little is known about test-retest variability for these measures. We hypothesized that even in a high volume echocardiography laboratory, quantitative measurements will demonstrate higher test-retest variability compared with inter-observer variability and intra-observer variability of the same measurements.Methods: Prospective study of uncomplicated, singleton pregnancies to evaluate fetal measures of cardiovascular function obtained by echocardiography. One sonographer obtained predefined variables, and then, a second sonographer obtained the same variables 15 minutes after the first sonographer. Separate data acquisitions were obtained by the two sonographers to evaluate test-retest variability. Intraobserver variability and inter-observer variability were also evaluated. Results:Thirty fetuses between 17-and 36-week gestation were enrolled. Timebased variables had the best intra-observer agreement and inter-observer agreement (1.2%-7.4%), while 2D (7.5%-10%), M-mode (4.9%-10.1%), and velocity-time integral (VTI; 2.6%-13.8%) measurements had poorer agreement. For all variables, test-retest agreement was worse (3%-32.1%), particularly for measurement of myocardial performance index (MPI; 19.7%-21.1%), cardiac output estimation (27.2%-27.9%), and VTI-based indices (14.7%-32.1%). Conclusions:In a laboratory highly experienced in quantitative fetal echocardiography, intra-observer agreement and inter-observer agreement are good for most quantitative parameters. However, test-retest agreement is fair or poor for several variables, notably the MPI, cardiac output estimation, and VTI-based indices.Understanding how these measures vary between separate acquisitions is important for clinical interpretation and decision making. K E Y W O R D SDoppler, fetal echocardiography, fetus, test-retest variability | 143 ALLEN Et AL. S U PP O RTI N G I N FO R M ATI O NAdditional supporting information may be found online in the Supporting Information section at the end of the article.Graph S1. Uncertainty (precision) of measurement based on sample size.

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Section: Discussionmentioning

confidence: 67%

mentioning

confidence: 60%

Section: Discussionmentioning

confidence: 97%

mentioning

confidence: 95%

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Test–retest variability for quantitative two‐dimensional and Doppler measurements in the fetus

et al. 2018

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“…Unfortunately, current technologies are able to sense and identify only a fraction of them. The fetal heart rate and its variability are the only parameters that can be obtained with sufficient accuracy at the moment (see [ 113 , 114 ]). However, the latest science and research suggests that the NI-fECG contains other, yet unexploited, clinically relevant data, see [ 115 ].…”

Section: Discussionmentioning

confidence: 99%

Non-Adaptive Methods for Fetal ECG Signal Processing: A Review and Appraisal

Jaroš

Martínek

Kahánková

2018

Sensors

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Fetal electrocardiography is among the most promising methods of modern electronic fetal monitoring. However, before they can be fully deployed in the clinical practice as a gold standard, the challenges associated with the signal quality must be solved. During the last two decades, a great amount of articles dealing with improving the quality of the fetal electrocardiogram signal acquired from the abdominal recordings have been introduced. This article aims to present an extensive literature survey of different non-adaptive signal processing methods applied for fetal electrocardiogram extraction and enhancement. It is limiting that a different non-adaptive method works well for each type of signal, but independent component analysis, principal component analysis and wavelet transforms are the most commonly published methods of signal processing and have good accuracy and speed of algorithms.

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Assessment of fetal myocardial performance index in pregnant women with SARS‐CoV‐2 infection: A prospective cohort study

Kahramanoğlu,

Akalin,

Bilir

et al. 2023

J of Clinical Ultrasound

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ObjectivesOur aim was to investigate the effects of the severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection on fetal myocardial performance in women who had it during their pregnancy.Materials and MethodsIn our prospective cohort study including healthy pregnant women and pregnant with SARS‐CoV‐2 infection, we collected patients' data between June 2021 and April 2022. Maternal characteristics, gestational age at SARS‐CoV‐2 infection and ultrasound examination, and body mass index were noted. Fetal biometry, fetal anatomy scanning, placenta, amniotic fluid index (AFI), and Doppler parameters were routinely examined in all patients. Left ventricular myocardial performance index (MPI) was measured during fetal echocardiography examination. Doppler parameters, AFI, and MPI values were compared between two groups.ResultsCompared with the control group (n = 80), MPI values were found within normal limits in fetuses of pregnant women with SARS‐CoV‐2 infection (n = 80) (MPI: 0.38 ± 0.06 in the control groups vs. 0.39 ± 0.05 in the SARS‐COV‐2 positive group, p = 0.79). There was no relationship between SARS‐CoV‐2 infection and changes in AFI and umbilical artery pulsatility index (PI) values. Uterine artery PI values were significantly higher in pregnant women with (SARS‐CoV‐2) infection (0.81 in the control group vs. 0.97 in the SARS‐CoV‐2 group, p < 0.05).ConclusionsFetal cardiac functions were not affected in pregnant women with previous (SARS‐CoV‐2) infection. Further metaanalyses are warranted to confirm the results.

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Beat‐to‐beat variability of fetal myocardial performance index

Cited by 6 publications

References 22 publications

Test–retest variability for quantitative two‐dimensional and Doppler measurements in the fetus

Test–retest variability for quantitative two‐dimensional and Doppler measurements in the fetus

Non-Adaptive Methods for Fetal ECG Signal Processing: A Review and Appraisal

Assessment of fetal myocardial performance index in pregnant women with SARS‐CoV‐2 infection: A prospective cohort study

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