Evaluation of the Human Fetal Cardiac Size and Function

Veille, Jean Claude; Sivakoff, Mark; Nemeth, Meg

doi:10.1055/s-2007-999447

Cited by 37 publications

(22 citation statements)

References 10 publications

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“…Cross-sectional measurements of the left and right ventricle using either orthogonal ventricular measurments28-30 or a biplane multiple-disc method, the Simpson rule,16 have also been used to estimate ventricular volumes. These methods require one to assume that the ventricle has a conical geometry or that the ventricular endocardium is smooth, neither of which is valid 31-33.…”

Section: Discussionmentioning

confidence: 99%

Repeatability and Reproducibility of Fetal Cardiac Ventricular Volume Calculations Using Spatiotemporal Image Correlation and Virtual Organ Computer-Aided Analysis

Hamill

Romero

Hassan

et al. 2009

Journal of Ultrasound in Medicine

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Objective To quantify the repeatability and reproducibility of fetal cardiac ventricular volumes obtained utilizing STIC and VOCAL™. Methods A technique was developed to compute ventricular volumes using the sub-feature: Contour Finder: Trace. Twenty-five normal pregnancies were evaluated for the following: (1) to compare the coefficient of variation (CV) in ventricular volumes between 15° and 30° rotation; (2) to compare the CV between three methods of quantifying ventricular volumes: (a) Manual Trace (b) Inversion Mode and (c) Contour Finder: Trace; and (3) to determine repeatability by calculating agreement and reliability of ventricular volumes when each STIC was measured twice by 3 observers. Reproducibility was assessed by obtaining two STICs from each of 44 normal pregnancies. For each STIC, 2 ventricular volume calculations were performed, and agreement and reliability were evaluated. Additionally, measurement error was examined. Results (1) Agreement was better with 15° rotation than 30° (15°: 3.6%, 95% CI: 3.0 – 4.2 versus 30°: 7.1%, 95% CI: 5.8 – 8.6; p<0.001); (2) ventricular volumes obtained with Contour Finder: Trace had better agreement than those obtained using either Inversion Mode (Contour Finder: Trace: 3.6%, 95% CI 3.0 – 4.2 versus Inversion Mode: 6.0%, 95% CI 4.9 – 7.2; p < 0.001) or Manual Trace (10.5%, 95% CI 8.7 – 12.5; p < 0.001); (3) ventricular volumes were repeatable with good agreement and excellent reliability for both intra-observer and inter-observer measurements; and 4) ventricular volumes were reproducible with negligible difference in agreement and good reliability. In addition, bias between STIC acquisitions was minimal (<1%; mean percent difference −0.4%, 95% limits of agreement: −5.4 – 5.9). Conclusions Fetal echocardiography utilizing STIC and VOCAL allows repeatable and reproducible calculation of ventricular volumes with the sub-feature Contour Finder: Trace.

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Section: Discussionmentioning

confidence: 99%

Repeatability and Reproducibility of Fetal Cardiac Ventricular Volume Calculations Using Spatiotemporal Image Correlation and Virtual Organ Computer-Aided Analysis

Hamill

Romero

Hassan

et al. 2009

Journal of Ultrasound in Medicine

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“…For example, it has been reported previously that cardiac output increases to match body growth by increasing ventricular dimensions (Veille et al, 1990). Whether this is a tandem or a sequential process, and, if the latter, which comes first-heart expansion or body growth-is presently undocumented.…”

Section: Normal Versus Compensatory Growthmentioning

confidence: 99%

Growth patterns of the heart and kidney suggest inter-organ collaboration in facultative fetal growth

Lampl

Kuzawa

Jeanty³

2005

Am. J. Hum. Biol.

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Maternal smoking during pregnancy has been associated with a number of negative sequelae among offspring, including elevated postnatal blood pressure. While animal studies have described organ level alterations with smoke exposure, human data have been more limited. Thirty-four healthy maternal/fetal pairs (24 nonsmokers, 10 smokers) participated in a longitudinal growth study from the thirteenth week of pregnancy to document fetal kidney and heart growth trajectories and morphology. Curve fitting followed by a mixed model for repeated measures identified significantly different growth patterns in kidney width, thickness, length, and volume growth with exposure: the smoke-exposed fetal kidney was wide and thick compared to the unexposed kidney during the second and early third trimester, declining to proportionately thin kidneys for length and width subsequently. Cardiac growth in width and volume followed a reverse pattern: a surge in cardiac volume occurred after 30 weeks with acceleration in cardiac width, resulting in a heart that was wide for length and for fetal weight. Smoke exposure altered fetal growth in size and timing of the heart and kidneys during midgestation, with changes in organ morphology suggesting compensatory growth. These are the first data providing anatomical evidence of altered renal/cardiac volume relationships that may provide a mechanism to previously reported sequelae of in utero smoke exposure. They suggest that cell-level adaptive responses to hypoxia and/or chemical insults are operative and illustrate the importance of longitudinal ultrasound to directly assess the organ-level growth response of the human fetus to a prenatal stress, in lieu of relying on birth outcome measures.

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“…Echocardiograms (including 2D, M mode and Doppler flow measurements [1][2][3] ) and later postmortem examinations were performed on these 2 fetuses. They both had endocardial fibroelastosis (EFE), 1 with critical aortic stenosis (no hydrops fetalis) and 1 with high-output cardiac failure (with hydrops fetalis), due to a rare case of diffuse placental chorioangiomatosis [4] .…”

Section: Case Reportmentioning

confidence: 99%

Echocardiographic Evaluation of Fetal Cardiac Function: Clinical and Anatomical Correlations in Two Cases of Endocardial Fibroelastosis

Clur

Wal²,

Ottenkamp

et al. 2010

Fetal Diagn Ther

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Background: Two fetuses with endocardial fibroelastosis, one with critical aortic stenosis and one with high-output cardiac failure due to chorioangiomatosis, are presented to evaluate the correlation between Doppler echocardiographic findings, the fetal clinical condition and the anatomical substrate found at postmortem. Methods: Doppler measurements of cardiac function (systolic, diastolic and global) and a cardiovascular score incorporating five parameters of fetal well-being were recorded. Results: In the fetus with critical aortic stenosis, the cardiovascular score was diminished, there was no hydrops, the systolic and global cardiac function indices were within normal limits but the diastolic function indices were abnormal. The fetus with high-output cardiac failure was hydropic, the cardiovascular score was diminished and abnormal Doppler indices of systolic, diastolic and global cardiac function were found. In both fetuses, abnormalities in the measured Doppler parameters were found consistent with clinical cardiac dysfunction and the postmortem findings. Conclusion: Recognition of abnormal diastolic function Doppler indices may assist in earlier identification of fetal cardiac compromise.

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Evaluation of the Human Fetal Cardiac Size and Function

Cited by 37 publications

References 10 publications

Repeatability and Reproducibility of Fetal Cardiac Ventricular Volume Calculations Using Spatiotemporal Image Correlation and Virtual Organ Computer-Aided Analysis

Repeatability and Reproducibility of Fetal Cardiac Ventricular Volume Calculations Using Spatiotemporal Image Correlation and Virtual Organ Computer-Aided Analysis

Growth patterns of the heart and kidney suggest inter-organ collaboration in facultative fetal growth

Echocardiographic Evaluation of Fetal Cardiac Function: Clinical and Anatomical Correlations in Two Cases of Endocardial Fibroelastosis

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