Evaluation of tissue Doppler-derived myocardial performance index in fetuses with intracardiac echogenic focus

Kurtulmuş, Seçil; Meşe, Timur; Taner, Cüneyt Eftal; Öztekin, Deniz; Okyay, D. Ozkale; Uysal, Ahmet; Uysal, Fatma; Cıngıllıoğlu, Başak

doi:10.3109/14767058.2013.797957

Cited by 6 publications

(11 citation statements)

References 29 publications

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“…An isolated finding of ICEF in a woman whose screening tests reported a low risk for trisomy 21 has a low predictive value for trisomy 21 and does not predict later cardiac function . However, the finding can cause the woman and her partner to worry about the fetus’ health.…”

Section: Resultsmentioning

confidence: 99%

“…ICEF is an ultrasound finding of an echogenic bright area in the fetal heart with the same brightness as bone that moves synchronically to the atrioventricular valves (Figure ). The echogenicity probably represents microcalcifications of the papillary muscles or chordae tendinae . ICEF is present at the midtrimester ultrasound in 3.5% of euploid fetuses and in 15% to 30% of fetuses with trisomy 21 .…”

Section: Intracardiac Echogenic Focusmentioning

confidence: 99%

“…ICEF is present at the midtrimester ultrasound in 3.5% of euploid fetuses and in 15% to 30% of fetuses with trisomy 21 . There can be one or multiple echogenic areas in the heart; they are most commonly found in the left ventricle . Although ICEF is more common in fetuses with trisomy 21 than in fetuses without trisomy 21, only about 11 to 15 of every 100 fetuses with an isolated ICEF will have trisomy 21 …”

Section: Intracardiac Echogenic Focusmentioning

confidence: 99%

“…Although ICEF is weakly associated with cardiac abnormalities, it is a poor predictor of long‐term cardiac outcomes and function . Systolic and diastolic function in 61 fetuses with ICEF were compared with 55 fetuses without ICEF using echocardiographic Doppler imaging of the myocardial tissue, and the isolated ICEF was not associated with cardiac dysfunction . The study authors concluded that fetuses with isolated ICEF and no structural or cardiac anomalies did not need fetal echocardiography (ECHO) to assess cardiac function .…”

Section: Intracardiac Echogenic Focusmentioning

confidence: 99%

“…Systolic and diastolic function in 61 fetuses with ICEF were compared with 55 fetuses without ICEF using echocardiographic Doppler imaging of the myocardial tissue, and the isolated ICEF was not associated with cardiac dysfunction . The study authors concluded that fetuses with isolated ICEF and no structural or cardiac anomalies did not need fetal echocardiography (ECHO) to assess cardiac function . Other studies have found that ICEF does not predict depressed cardiac function in the fetus and is not associated with myocardial dysfunction from birth to 24 months of age using fetal ECHO, electrocardiogram, and 24‐hour ambulatory Holter monitoring …”

Section: Intracardiac Echogenic Focusmentioning

confidence: 99%

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Isolated Intracardiac Echogenic Focus on Routine Ultrasound: Implications for Practice

Murphy¹,

Phillippi²

2015

J Midwife Womens Health

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Ultrasound is widely used as a screening tool for fetal anomalies. An intracardiac echogenic focus (ICEF) is associated with fetal aneuploidy, particularly trisomy 21, when found with other minor abnormalities known as soft markers. However, when found in isolation, intracardiac echogenic foci are morphologic variations with little or no pathologic significance for the fetus. Ambiguity about the significance of ICEF and other soft markers and the lack of preparation prior to ultrasound can result in unnecessary worry for women and their partners. A variety of tools exist that providers can use to help pregnant women and their partners make informed decisions about ultrasound and fetal screening.

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Section: Resultsmentioning

confidence: 99%

Section: Intracardiac Echogenic Focusmentioning

confidence: 99%

Section: Intracardiac Echogenic Focusmentioning

confidence: 99%

Section: Intracardiac Echogenic Focusmentioning

confidence: 99%

Section: Intracardiac Echogenic Focusmentioning

confidence: 99%

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Isolated Intracardiac Echogenic Focus on Routine Ultrasound: Implications for Practice

Murphy¹,

Phillippi²

2015

J Midwife Womens Health

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Poor Correlation between Fetal Tissue Doppler Imaging and Pulsed Wave Myocardial Performance Indices

Avnet¹,

Thomas²,

Beirne³

et al. 2023

Fetal Diagn Ther

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Introduction: Both Tissue Doppler Imaging (TDI) and Pulsed Wave Doppler (PWD) Myocardial Performance Indices (MPI) have been proposed as tools for functional fetal cardiology. We wished to determine if there was any correlation between TDI MPI and PWD MPI. Methods: A cohort of uncomplicated women with morphologically normal singleton fetuses between 22 and 39 weeks gestation were recruited. A single sonologist acquired Doppler waveforms for evaluation of both left and right TDI-MPI and PWD-MPI. The PWD MPI values were calculated using a previously published algorithm and the TDI MPI time intervals were measured manually by a single operator. Results: Achievability and repeatability were high for both modalities. TDI produced significantly lower right MPI values, yet significantly higher left MPI values, potentially reflecting their evaluation of physiologically different events, blood flow versus myocardial contraction. Discussion/Conclusion: This study demonstrates that MPI measured from PWD and TDI have a weak correlation and cannot be used interchangeably, even with the exclusion of suboptimal TDI-MPI scans from the analysis. Given the lack of correlation between the two methods, the high variation in TDI waveform and the lack of unified approach to TDI analysis we feel further research is needed before adoption of this technique.

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Echogenic intracardiac foci detection and location in the second-trimester ultrasound and association with fetal outcomes: A systematic literature review

Jones,

Battaglia,

Hurt

et al. 2024

PLoS ONE

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Background Echogenic Intracardiac Foci (EIF) are non-structural markers identified during the routine 18–20-week foetal anomaly ultrasound scan yet their clinical significance on future outcomes for the infant is unclear. Objective To examine the association between EIF and risk of preterm birth, chromosomal abnormalities, and cardiac abnormalities. Design A review across four databases to identify English language journal articles of EIF using a cohort study design. All studies were reviewed for quality using the Critical Appraisal Skills Programme (CASP) checklist and data extracted for comparison and analysis. Results 19 papers from 9 different countries were included. Combining these studies showed 4.6% (95% CI = 4.55–4.65%) of all pregnancies had EIF which was on the left in 86% of cases, on the right in 3% of cases and bilaterally in 10%. There was no evidence that EIF was associated with higher rates of preterm birth. However, it is possible that infants with EIF were more likely to be terminated rather than be born preterm as there was a 2.1% (range 0.3–4.2%) rate of termination or death of the foetus after week 20 among those with EIF. There was no evidence that EIF alone is highly predictive of chromosomal abnormalities. There was evidence that EIF is associated with higher rates of minor cardiac abnormalities (e.g. ventricular septal defect, tricuspid regurgitation or mitral regurgitation)) with 5.1% (224 of 4385) of those with EIF showing cardiac abnormalities (3.08% in retrospective studies and 17.85% in prospective studies). However, the risk of cardiac defects was only higher with right-sided EIF and where the EIF persisted into the third trimester. However, this is a rare event and would be seen in an estimated 4 per 10,000 pregnancies. Conclusion EIF alone was not associated with adverse outcomes for the infant. Only persistent EIF on the right side showed evidence of carrying a higher risk of cardiac abnormality and would warrant further follow-up.

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Evaluation of tissue Doppler-derived myocardial performance index in fetuses with intracardiac echogenic focus

Cited by 6 publications

References 29 publications

Isolated Intracardiac Echogenic Focus on Routine Ultrasound: Implications for Practice

Isolated Intracardiac Echogenic Focus on Routine Ultrasound: Implications for Practice

Poor Correlation between Fetal Tissue Doppler Imaging and Pulsed Wave Myocardial Performance Indices

Echogenic intracardiac foci detection and location in the second-trimester ultrasound and association with fetal outcomes: A systematic literature review

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