Impaired Elastic Properties of the Ascending Aorta in Fetuses With Coarctation of the Aorta

Xu, Ran; Zhou, Dan; Liu, Yushan; Yao, Longmei; Xie, Li; Liu, Minghui; Zhou, Qing; Zeng, Shi

doi:10.1161/jaha.122.028015

Cited by 3 publications

(6 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…33 Fetal HQ can determine LV-FAC, RV-FAC, LV-LS, and RV-LS and divide the ventricles into 24 segments and analyze each segment's FS changes. This study shows that when compared with the control group, the left ventricle's overall systolic function, longitudinal contractile function, and lateral contractile function were inhibited in fetuses in the CoA group, whereas these parameters were inhibited in the right ventricle's basal and middle segments, which is consistent with the findings of DeVore et al 21,22 Xu et al 34 reported reduced fetal ventricular FAC in the CoA group, and a study by Liu et al 26 that involved 122 fetuses with CoA reported that LV-FAC and LV-LS were reduced in fetuses with CoA, although there were no significant changes in RV-FAC and RV-LS. Fetal cardiomyocytes are susceptible to hypoxia, which leads to sarcomere shortening in myocardial cells, which are an important component of myocardial contraction.…”

Section: Discussionsupporting

confidence: 91%

Assessing Coarctation of the Aorta With Fetal Heart Quantification Technology

Yang,

Tan,

Shen

et al. 2024

Maternal Fetal Med

View full text Add to dashboard Cite

Objective To use fetal heart quantification (fetal HQ) technology to compare the coarctation of the aorta (CoA) and normal fetal heart structure and systolic function and to assess whether there are abnormalities in the fetal heart structure and systolic function associated with CoA. Methods This prospective cohort study was conducted from May 2020 to December 2022 and involved 18–40-week-old singleton pregnancies and 30 fetuses diagnosed with CoA using fetal echocardiography at the General Hospital of Ningxia Medical University and Peking University First Hospital Ningxia Women’s and Children’s Hospital, China. The control group contained 60 normal fetuses. The following parameters were recorded and analyzed statistically: four-chamber view (4CV) end-diastolic long diameter, 4CV epicardial–contralateral epicardial transverse maximum diameter, 4CV global sphericity index (GSI), left ventricular (LV) and right ventricular (RV) 24-segment end-diastolic diameter (EDD), 24-segment sphericity index (SI), LV-fractional area change (LV-FAC), LV-longitudinal strain (LV-LS), RV-fractional area change (RV-FAC), RV-longitudinal strain (RV-LS), and LV and RV 24-segment transverse fractional shortening (FS). Measurement data were compared between the two groups using an independent sample t test, with P < 0.05 indicating statistically significant differences. Moreover, the correlation between gestational age and GSI, LV-FAC, LV-LS, RV-FAC, and RV-LS was assessed. Results Within and between observer comparisons of the parameters associated with major cardiac function revealed an intragroup correlation coefficient of >0.9, indicating high consistency, and a coefficient of variable of <1%, indicating low variability. Correlation analysis revealed no obvious correlation between gestational age and GSI, LV-FAC, LV-LS, RV-FAC, and RV-LS. A comparison of the four-chamber morphological structural parameters of the hearts in the two groups revealed that when compared with the control group, the 4CV end-diastolic long diameter was shortened in fetuses in the CoA group and the epicardial–contralateral epicardial transverse maximum diameter was wider, while the GSI was lower (P < 0.05). A comparison of the LV and RV morphological structure parameters between the two groups revealed that when compared with the control group, the LV’s 24-segment EDD was smaller in the CoA group, the RV’s 24-segment EDD was greater in the control group, the SI of the LV’s segments 16–24 was greater than in the control group, and the SI of the RV’s segments 7–24 was less than in the control group (all P < 0.05). When compared with fetuses in the control group, the LV’s segments 16–24 were greater in the CoA group, whereas the RV’s segment 6–24 was smaller (P < 0.05). When compared with the control group, LV-FAC, RV-FAC, and LS were lower in the CoA group (P < 0.05). The FS of the LV segments 1–24 and the FS of the RV segments 1–16 were smaller in the CoA group than in the normal group (P < 0.05). Conclusion Fetal HQ, a new simple technique that offers rapid analysis and high repeatability, can quantitatively evaluate structural and systolic function changes in fetuses with CoA.

show abstract

Section: Discussionsupporting

confidence: 91%

Assessing Coarctation of the Aorta With Fetal Heart Quantification Technology

Yang,

Tan,

Shen

et al. 2024

Maternal Fetal Med

View full text Add to dashboard Cite

show abstract

“…This finding is similar to that in a previous study by Vyas et al in which fetuses with hypoplastic left heart syndrome presented decreased MPI 30 . Altered MPI in the fetuses with CoA is also consistent with another study by our team on fetal aortic elastic properties 31 . Previous studies have put forth the proposition that the impaired myocardial deformation observed in fetuses with CoA may be attributed to abnormal intrinsic myocardial structure 32,33 .…”

Section: Discussionsupporting

confidence: 87%

“…23 Our previous study showed impaired aortic elastic properties in fetuses with CoA. 31 Abnormal aortic stiffness and left ventricular outflow tract orientation may affect vortex flow in the aorta. Though no significant correlation was found between LV vortex geometry and aortic isthmus size, additional research is needed to evaluate the relationship between vortex flow and left ventricular outflow tract orientation, as well as aortic elastic properties in CoA.…”

Section: Discussionmentioning

confidence: 97%

“…30 Altered MPI in the fetuses with CoA is also consistent with another study by our team on fetal aortic elastic properties. 31 Previous studies have put forth the proposition that the impaired myocardial deformation observed in fetuses with CoA may be attributed to abnormal intrinsic myocardial structure. 32,33 However, the exact nature of cardiac asymmetry and remodeling in fetuses with CoA remains unclear.…”

Section: Discussionmentioning

confidence: 99%

“…Prior study demonstrates that vortex flow would have impact on stroke output and efficiency of momentum transfer in LV by redirection of intraventricular flow 23 . Our previous study showed impaired aortic elastic properties in fetuses with CoA 31 . Abnormal aortic stiffness and left ventricular outflow tract orientation may affect vortex flow in the aorta.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Left Ventricular Vortex Characteristics in Fetuses With Coarctation of the Aorta by Blood Speckle‐Tracking Echocardiography

Zhou,

Xu,

Liu

et al. 2024

J of Ultrasound Medicine

Self Cite

View full text Add to dashboard Cite

ObjectivesThe aims of this study were to assess the vortex characteristics of left ventricle (LV) in fetuses with coarctation of the aorta (CoA) using high–frame rate ultrasound with blood speckle‐tracking (BST) and explore its relationships with cardiac function and morphology parameters.MethodsThirty fetuses with CoA and 30 gestational‐age matched normal fetuses were included in this cross‐sectional study. The area, length, width, and position of the vortex in the LV were recorded and quantitatively analyzed by BST echocardiography. The associations of vortex properties with ventricular function and morphology were also determined.ResultsBased on BST imaging, the LV vortex can be observed in 93% of the fetuses. The fetuses with CoA exhibited significantly larger and wider vortex than the controls (P < .05). Linear regression analysis indicated that vortex area was positively related to sphericity index of LV as well as isovolumic relaxation time (r = .52, P = .003 and r = .42, P = .021). There was a negative correlation between vortex area and mitral valve size (r = −.443, P = .014). No significant association was found between vortex area and myocardial performance index and aortic isthmus size.ConclusionsIt is feasible to quantitatively evaluate the left ventricular vortex in fetuses by BST. The fetuses with CoA exhibited greater vortex area and width, and the altered vortex property is associated with geometry of LV. This will facilitate our comprehension of the unique flow patterns and early cardiac remodeling in fetuses with CoA.

show abstract

Left ventricle inflow and outflow tract angle in normal fetuses

Yang,

Xu,

Tan

et al. 2023

Front. Cardiovasc. Med.

View full text Add to dashboard Cite

ObjectiveImpaired elasticity of aorta has been observed in fetuses with congenital cardiac disease, while the orientation of left ventricle outflow tract has been found to influence the blood flow in the ascending aorta. Therefore, the objective of this study is to examine the left ventricle inflow and outflow tract angle (LIOA) in healthy fetuses.MethodA total of 668 fetuses were enrolled in this prospective study. The LIOA were measured with two-line method at left ventricle inflow and outflow tract view. Pearson's correlation coefficient was utilized to assess the associations between LIOA and estimated fetal weight (EFW) and cardiac dimensions, including cardiac axis and diameters of aortic valve (AV), pulmonary artery valve (PAV), mitral valve (MV) and tricuspid valve (TV).ResultsThe LIOA was determined to be 44 ± 7.5° (mean ± SD). No significant difference was observed in the LIOA across different gestational ages (GAs). A mild positive correlation was observed between LIOA and cardiac axis. However, no significant associations were found between LIOA and parameters such as EFW, as well as diameters of AV, PAV, MV and TV.ConclusionThe LIOA remained constant during the mid-third trimester and was mildly positively correlated with cardiac axis in normal fetuses.

show abstract

Impaired Elastic Properties of the Ascending Aorta in Fetuses With Coarctation of the Aorta

Cited by 3 publications

References 27 publications

Assessing Coarctation of the Aorta With Fetal Heart Quantification Technology

Assessing Coarctation of the Aorta With Fetal Heart Quantification Technology

Left Ventricular Vortex Characteristics in Fetuses With Coarctation of the Aorta by Blood Speckle‐Tracking Echocardiography

Left ventricle inflow and outflow tract angle in normal fetuses

Contact Info

Product

Resources

About