Tissue Doppler imaging of the fetal heart

Paladini, D.; Lamberti, A.; Teodoro, A.; Arienzo, Mariapaola; Tartaglione, Antonio; Martinelli, Pasquale

doi:10.1046/j.1469-0705.2000.00251.x

Cited by 72 publications

(57 citation statements)

References 17 publications

(20 reference statements)

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“…In cardiology the method is mostly used for the assessment of contractility, generally in conjunction with M-mode tissue Doppler imaging ( Figure 3). In fetal cardiology the method is still in its early stages, awaiting a clinical application 59,60 . The future will show whether the assessment of diastolic function and wall movements' velocities in the fetus are of diagnostic value.…”

Section: Tissue Doppler Imagingmentioning

confidence: 99%

Fetal echo cardiography: the state of the art of the state of the heart

Chaoui¹

2001

Ultrasound in Obstet & Gyne

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Section: Tissue Doppler Imagingmentioning

confidence: 99%

Fetal echo cardiography: the state of the art of the state of the heart

Chaoui¹

2001

Ultrasound in Obstet & Gyne

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“…[7][8][9][10] In addition, it has been reported that the E/Ea ratio is significantly higher in fetuses with right ventricular (RV) heart failure. 11 However, there is a paucity of data with respect to abnormalities in the fetal heart.…”

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confidence: 99%

Characterization of Ventricular Myocardial Performance in the Fetus by Tissue Doppler Imaging

Watanabe

Hashimoto

Saito

et al. 2009

Circ J

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Background: Clinically useful indices of fetal cardiac function have not been fully delineated for tissue Doppler imaging (TDI). Methods and Results:In the present study, 56 pregnancies between the 17 th and 38 th weeks of gestation included 38 normal fetuses, 6 cases of hydrops fetalis (HF), and 12 of intrauterine growth retardation (IUGR). Peak velocity in early diastole (E) was measured by pulsed-wave Doppler and the peak annular velocities in systole (Sa) and early diastole (Ea) were measured by TDI. The ratio between flow velocity and annular velocity in early diastole (E/Ea) and the ratio of the Sa of right ventricle to that of the left ventricle (RVSa/LVSa) were estimated. In all fetuses with HF, LVSa was <2 cm/s and LVE/Ea was >13. RVSa/LVSa in the HF group was significantly higher than that in the normal group, and RVSa/LVSa in the IUGR group was significantly lower than that in the normal group. Conclusions: A combination of low LVSa and high LVE/Ea shows reduced global myocardial performance of the LV, and would be one of the useful indices for quantitative assessment in high-risk pregnancies. Changes in the RVSa/LVSa ratio may reflect afterload changes in both ventricles and compensatory cardiovascular mechanisms occurring during the process of placental insufficiency and heart failure. (Circ J 2009; 73: 943 -947)

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“…Echocardiography has been applied to assess fetal cardiac function noninvasively in a variety of clinical conditions, such as intrauterine growth restriction (29), hydrops (17), congenital heart disease (38), and twin-twin transfusion syndrome (36). Recently, tissue Doppler imaging (TDI) of myocardial motion has been introduced in clinical practice as a promising new technique in the assessment of fetal heart function (2,8,11,15,32,34).In human pregnancies, placental insufficiency with increased placental vascular resistance (R ua ) can lead to fetal metabolic acidosis and death. Our experiments in a chronic sheep model of increased R ua were designed to test the hypothesis that acute metabolic acidosis decreases fetal myocardial motion.…”

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confidence: 99%

Metabolic acidosis decreases fetal myocardial isovolumic velocities in a chronic sheep model of increased placental vascular resistance

Acharya

Räsänen²,

Mäkikallio

et al. 2008

American Journal of Physiology-Heart and Circulatory Physiology

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Acharya G, Räsänen J, Mäkikallio K, Erkinaro T, Kavasmaa T, Haapsamo M, Mertens L, Huhta JC. Metabolic acidosis decreases fetal myocardial isovolumic velocities in a chronic sheep model of increased placental vascular resistance. Am J Physiol Heart Circ Physiol 294: H498-H504, 2008. First published November 16, 2007 doi:10.1152/ajpheart.00492.2007.-We hypothesized that acute fetal metabolic acidosis decreases fetal myocardial motion in a chronic sheep model of increased placental vascular resistance (Rua). Eleven ewes and fetuses were instrumented at 118 -122 days of gestation. After 5 days of recovery and 24 h of placental embolization to increase Rua, longitudinal myocardial velocities of the right and left ventricles and interventricular septum (IVS) were assessed at the level of the atrioventricular valve annuli via tissue Doppler imaging (TDI). Ventricular inflow (E and A waves) and outflow velocities were obtained, and cardiac outputs were calculated. All measurements were performed at baseline and during fetal acidosis caused by epidural anesthesia-induced maternal hypotension, which decreased uterine artery volume blood flow, fetal oxygenation, arterial pH, and base excess and increased lactate. Compared with baseline, the peak isovolumic myocardial contraction and relaxation velocities of the ventricles and IVS, early relaxation velocity (EЈ) of the ventricles, and systolic velocity of the IVS decreased during metabolic acidosis. The proportion of isovolumic contraction time of the cardiac cycle increased but the isovolumic relaxation and ejection time proportions and the TDI Tei index did not change. The E-to-EЈ ratio for both ventricles was higher during metabolic acidosis than at baseline. During metabolic acidosis, right and left ventricular cardiac outputs remained unchanged compared with baseline. In sheep fetuses with increased Rua and acute metabolic acidosis, global cardiac function was preserved. However, acute metabolic acidosis impaired myocardial contractility during the isovolumic phase and relaxation during the isovolumic and early filling phases of the cardiac cycle. cardiac function; fetal echocardiography; tissue Doppler IN RESPONSE TO HYPOXEMIA, fetuses generally redistribute more blood toward the myocardium, brain, and adrenal glands at the expense of the lower body and viscera (3,22). The fetal heart is known to have a remarkable ability to withstand hypoxia (10, 30), but progressive hypoxia and acidosis may decrease blood supply to the heart (6) and alter myocardial energy metabolism (18,40). However, despite reduced myocardial contractility, global cardiac function is preserved during moderate acidemia (26). Echocardiography has been applied to assess fetal cardiac function noninvasively in a variety of clinical conditions, such as intrauterine growth restriction (29), hydrops (17), congenital heart disease (38), and twin-twin transfusion syndrome (36). Recently, tissue Doppler imaging (TDI) of myocardial motion has been introduced in clinical practice as a promising new techniqu...

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Tissue Doppler imaging of the fetal heart

Abstract: TDI evaluation of the fetal heart is feasible and reproducible. Color-TDI is able to identify the various phases of the cardiac cycle. Quantitative evaluation of myocardial velocities has shown also in the fetus the existence of the myocardial velocity gradient found in postnatal life.

Cited by 72 publications

References 17 publications

Fetal echo cardiography: the state of the art of the state of the heart

Fetal echo cardiography: the state of the art of the state of the heart

Characterization of Ventricular Myocardial Performance in the Fetus by Tissue Doppler Imaging

Metabolic acidosis decreases fetal myocardial isovolumic velocities in a chronic sheep model of increased placental vascular resistance

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