Evaluation of right ventricular function in fetal hypoplastic left heart syndrome by color tissue Doppler imaging

Graupner, O; Enzensberger, C; Wieg, L; Willruth, A.; Steinhard, J.; Gembruch, Ulrich; Doelle, A; Bahlmann, Franz; Kawecki, A; Degenhardt, J; Wolter, A; Herrmann, Jens; Axt-Fliedner, R

doi:10.1002/uog.14940

Cited by 21 publications

(32 citation statements)

References 40 publications

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“…Therefore, published tissue velocities vary and cannot be used interchangeably. Absolut values of s´ velocities in both groups were comparable, suggesting a preserved systolic function of the right ventricle in fetuses with HLHS, which is in line with our previous results 12,13 . Second, we found highest tissue velocities at the base of the heart at the atrioventricular valve level significantly decreasing towards the apex of the heart within the right ventricle in HLHS and normal fetuses.…”

confidence: 91%

“…First, lower e' velocities measured in the tricuspid annulus and the right ventricular free wall in HLHS compared to healthy control fetuses might provide further evidence of altered ventricular diastolic function. We previously described a lower e´ velocity and e´/a´ ratio reflecting an impaired ventricular relaxation during early diastole in fetuses with HLHS using a drawn ROI, which covers the middle and basal part of the right ventricular wall 13 . In comparison to our previous findings we observed an increase in diastolic velocities (e´, a´) of the basal part in control fetuses during gestation.…”

Section: Discussionmentioning

confidence: 99%

“…For the final analysis, a total of 20 HLHS fetuses (of a total cohort of 32 HLHS fetuses during the study period) and 20 gestational age-matched controls were included. The cohort was in part analysed previously describing PW-TDI and c-TDI techniques, demographic data were described before 12,13 .…”

Section: Methodsmentioning

confidence: 99%

“…The peak tissue velocities along the axis at systole (s´), early filling phase of diastole (e´) and during atrial contraction (a´) were averaged from three consecutive cardiac cycles as previously described 13 .…”

Section: Fetal Echocardiographymentioning

confidence: 99%

“…This work represents a secondary analysis of prior work from our study group concerning evaluation of right ventricular function in fetal HLHS by c-TDI 13 . The purpose of this study was to evaluate individual myocardial displacement and tissue Doppler velocities within three different regions of the right ventricle (base, middle part, apex) and to look for a possible gradient from base to apex from which is known that it normally exists in adult heart corresponding to the stationarity of the apex within the thorax while the base moves towards it.…”

Section: Introductionmentioning

confidence: 99%

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Segmental Myocardial Displacement and Tissue Velocity Analysis of the Right Ventricle in Hypoplastic Left Heart Syndrome Fetuses and Controls Using Color Tissue Doppler Imaging (C-TDI)

Graupner

Enzensberger

Wieg

et al. 2017

Prenatal Cardiology

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Introduction: The long-term outcome of patients with HLHS (hypoplastic left heart syndrome) is mainly determined by right ventricular function. Our study examines, whether there are differences in segmental right ventricular myocardial displacement and tissue velocities of fetuses with HLHS compared to healthy fetuses during gestation.Materials and methods: A prospective study was conducted including 20 fetuses with HLHS and 20 gestational age matched controls. c-TDI (colour tissue Doppler imaging) derived systolic and diastolic velocities as well as myocardial displacement were assessed in three different locations of the right ventricle (RV). A ROI (region of interest) was placed in the basal, middle and apical part of the myocardium. Possible changes of c-TDI indices in the course of pregnancy and between the three different segments were investigated in both groups.Results: HLHS fetuses showed significantly lower e' velocities measured in the basal and middle part of the RV compared to healthy controls (p < 0.05). Basal displacement showed significantly lower values in HLHS fetuses compared to controls. In control fetuses but not in HLHS fetuses there was a significant increase of basal diastolic velocities and displacement in the course of pregnancy. According to myocardial velocities and displacement values there was a significant decrease from the base of the fetal heart to the apex pointed in both groups.Conclusions: An altered right ventricular myocardial function in HLHS fetuses within different myocardial segments could be demonstrated. An apicobasal gradient with higher velocity and displacement values in the basal part of RV myocardium could be found in both groups. The technique may be of value in the prenatal assessment of myocardial function, however its role as a monitoring tool and outcome predictor needs to be defined.

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confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Fetal Echocardiographymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Segmental Myocardial Displacement and Tissue Velocity Analysis of the Right Ventricle in Hypoplastic Left Heart Syndrome Fetuses and Controls Using Color Tissue Doppler Imaging (C-TDI)

Graupner

Enzensberger

Wieg

et al. 2017

Prenatal Cardiology

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Prenatal diagnosis of functionally univentricular heart, associations and perinatal outcomes

et al. 2016

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Myocardial function in fetuses with lower urinary tract obstruction: Is there a cardiac remodeling effect due to renal damage?

et al. 2019

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Objectives: Cardiac remodeling due to renal dysfunction may have an impact on myocardial function (MF) of fetuses with lower urinary tract obstruction (LUTO).The aim was to identify possible differences in MF in LUTO fetuses compared with healthy controls and to look for interactions between urine biochemistry and MF indices.Methods: This is a cohort study consisting of 31 LUTO fetuses and 45 healthy controls. Subgroups were generated according to intrauterine therapy (group 1: LUTO after therapy, group 2: LUTO without therapy at the time of examination, and group 3: controls). MF indices were measured using pulsed wave tissue Doppler imaging and M-mode. Furthermore, results of fetal urine biochemistry were gathered retrospectively.

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Evaluation of right ventricular function in fetal hypoplastic left heart syndrome by color tissue Doppler imaging

Abstract: Right ventricular function in HLHS is altered as early as in fetal life, well before palliative surgery is performed. Future research should provide further insight into ventricular remodeling during gestation in cases of HLHS. Copyright © 2015 ISUOG. Published by John Wiley & Sons Ltd.

Cited by 21 publications

References 40 publications

Segmental Myocardial Displacement and Tissue Velocity Analysis of the Right Ventricle in Hypoplastic Left Heart Syndrome Fetuses and Controls Using Color Tissue Doppler Imaging (C-TDI)

Segmental Myocardial Displacement and Tissue Velocity Analysis of the Right Ventricle in Hypoplastic Left Heart Syndrome Fetuses and Controls Using Color Tissue Doppler Imaging (C-TDI)

Prenatal diagnosis of functionally univentricular heart, associations and perinatal outcomes

Myocardial function in fetuses with lower urinary tract obstruction: Is there a cardiac remodeling effect due to renal damage?

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