Objective
To determine if increased placental vascular impedance to flow is associated with changes in fetal cardiac function using spatiotemporal image correlation (STIC) and Virtual Organ Computer-aided AnaLysis (VOCAL).
Study Design
A cross-sectional study was performed in fetuses with an umbilical artery pulsatility index > 95th percentile (ABN). Ventricular volume (end-systole, end-diastole), stroke volume (SV), cardiac output (CO), adjusted CO, and ejection fraction (EF) were compared to those of 184 normal fetuses (NL).
Results
1) 34 fetuses were evaluated at a median gestational age of 28.3 (range 20.6 – 36.9) weeks; 2) mean ventricular volumes were lower for ABN than NL (end-systole, end-diastole) with a proportionally greater decrease for left ventricular volume (vs. right); 3) mean left and right SV, CO, and adjusted CO were lower for ABN (vs. NL); 4) right ventricular volume, SV, CO, and adjusted CO exceeded the left in ABN fetuses; 5) mean EF was greater for ABN than NL; and 6) median left EF was greater (vs. right) in ABN fetuses.
Conclusion
Increased placental vascular impedance to flow is associated with changes in fetal cardiac function.