Utility of the modified myocardial performance index in growth‐restricted fetuses

Öcal, Fatma Doğa; Yakut, Kadriye; Öztürk, Filiz Halıcı; Öztürk, Merve; Oğuz, Yüksel; Altınboğa, Orhan; Çelen, Şevki

doi:10.1111/echo.14489

Cited by 14 publications

(21 citation statements)

References 42 publications

(53 reference statements)

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“…The present study showed that the normal Mod-MPI measurements of our pregnant population (0.4 [0.21-0.67]) were consistent with the reference intervals reported in previous studies. [15][16][17][18][19] Additionally, in our study the Mod-MPI values increased with GA, which is similar to the results reported by Cruz-Martinez et al 19 who found a positive correlation between Mod-MPI and GA.…”

Section: Discussionsupporting

confidence: 90%

“…However, IRT values, the earliest influenced component of MPI, were significantly lower in the FGR group than in the control group. 17 Another study performed by Kır et al 18 investigated the importance of MPI in children diagnosed with isolated ventricular septal defect (VSD). The MPI values were found to be significantly higher in children with VSD than in healthy children, and the mean MPI values in healthy children were 0,26 ± 0,005.…”

Section: Discussionmentioning

confidence: 99%

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Turkish reference ranges for the left fetal modified myocardial performance index

Yakut¹,

Öcal²,

Öztürk³

et al. 2021

Turk J Pediatr

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Background. This study aimed to assess fetal cardiac left ventricular function in healthy pregnant women by calculating the modified myocardial performance index (Mod-MPI) and to construct reference ranges for the Turkish population.Methods. One-hundred-two randomly selected healthy singleton pregnant women ranging between 25 and 39 gestational weeks were included in the study. Left fetal Mod-MPI was measured for each pregnant woman. Women with chronic systemic diseases or fetuses with chromosomal or structural abnormalities were excluded from the study. Mitral valve (MV) and aortic valve (AoV) clicks were used as landmarks to define the following time periods that were used to calculate the Mod-MPI: isovolumetric contraction time (ICT), isovolumetric relaxation time (IRT), and ejection time (ET).Results. The mean Mod-MPI was 0.42±0.10. The mean IRT, ICT, and ET were 43.5±10.2, 27.27±8.1, and 170.5±16.9, respectively. A significant correlation was found between Mod-MPI and gestational age, umbilical artery systolic/diastolic (UA S/D) ratio and the middle cerebral artery pulsatility index (MCA PI) values (r=0.199, p=0.047, p=0.001, p=0.001, respectively) Conclusions. The current study's results will be a reference for future studies, especially studies investigating pathological conditions that impact fetal cardiac function.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Turkish reference ranges for the left fetal modified myocardial performance index

Yakut¹,

Öcal²,

Öztürk³

et al. 2021

Turk J Pediatr

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“…At our study, 35 fetuses out of 40 [87.5%] had abnormal left mod-MPI value. Other authors have found no significant difference between the left MPI measurements of normal-growth fetuses, when compared to those fetuses with IUGR [22] .…”

Section: Discussionmentioning

confidence: 85%

“…The large multicenter prospective study in fetuses with IUGR have found only a modest increase in the left mod-MPI and that was not of clinical utility in comparison to the assessment of umbilical artery and ductus venous [DV] Doppler [1] . Öcal et al [22] have reported that, there were no significant difference between-groups [cases and controls] in the left MPI. This results contradicts to the current study.…”

Section: Discussionmentioning

confidence: 95%

“…Several methods to obtain the left MPI have been used, with one modification which used the valvular clicks to identify the time intervals, this technique has been used in our study, and it was not used in all previous studies examining the left MPI, and this created a lot of differences between results. Another reason, the left MPI values altered depending on fetal circulatory loading [22] .…”

Section: Discussionmentioning

confidence: 99%

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The Prediction of Adverse Perinatal Outcomes in Intrauterine Growth Restriction using the Doppler Indices of Myocardial Performance and Aortic Isthmus

Bellehy

Omar

Eid

et al. 2020

International Journal of Medical Arts

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Background: Intrauterine growth restriction [IUGR] represented a challenging health problem, faced during daily clinical practice. Early diagnosis is of crucial importance. Aim of the work: To determine the value of the aortic isthmic flow index and the left mod-myocardial performance index [MPI] in the prediction of adverse perinatal outcomes in fetuses affected by IUGR. Patients and Methods: Forty Singleton fetuses with IUGR between 28 and 34 weeks were recruited. The left mod-MPI and the isthmic flow index [IFI] were calculated. Ultrasound indices had been correlated with perinatal outcome. Results: There was a statistically significant association between abnormal aortic isthmus diastolic flow and low 1-minute Apgar score and neonatal intensive care unit [NICU] admission. There was a statistically significant association between the left mod-MPI and the meconium stained amniotic fluid [AF], the need for Neonatal resuscitation, NICU admission, neonatal sepsis, and neonatal death. When considering cutoff value for prediction of adverse fetal outcome by Left MPI, a cutoff of 0.53 confers 85.2% sensitivity, 80% specificity, PPV 92%, NPV 66.7%, and accuracy of 83.8%. In addition, 85% of fetuses had normal Aortic isthmus [AoI] waveform [IFI type I] and 15% had abnormal AoI waveform, and there was a statistically significant association between abnormal AoI diastolic flow and each of [IFI of II, III, V], [low 1-minute Apgar score] and [NICU admission]. Conclusion: AoI IFI and left mod-MPI could be considered valuable for the assessment of chronic placental insufficiency, and play a role in prediction of adverse perinatal outcome associated with IUGR.

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Assessment of fetal cardiac morphology and functional changes in early‐onset and late‐onset fetal growth restriction

Oluklu

Beşer

Hendem

et al. 2022

Intl J Gynecology & Obste

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Objective To compare the fetal cardiac morphology and functions of early‐onset fetal growth restriction (EO‐FGR) and late‐onset fetal growth restriction (LO‐FGR) groups with gestational weeks‐matched controls. Methods A total of 164 pregnant women were included, 28 of whom were in the EO‐FGR group, 54 in the LO‐FGR group, and 82 in the control group. Fetal echocardiographic evaluation was performed with two‐dimensional, M‐mode, tissue Doppler imaging (TDI), and pulsed wave Doppler. Results Fetal cardiac morphologic measurements and diastolic and systolic functions changed in EO‐FGR and LO‐FGR fetuses compared with controls. The EO‐ and LO‐FGR fetuses had reduced right and left cardiac output, increased myocardial performance index, and significantly higher mitral and tricuspid E/E' ratios compared with controls. The EO‐FGR fetuses had lower mitral and tricuspid E and E' values. In LO‐FGR fetuses, mitral and tricuspid E' values were lower than in their controls (P = 0.001 and P < 0.001). On the other hand, the mitral and tricuspid E values were not significantly changed (P = 0.107 and P = 0.196). Conclusion We hypothesized that EO‐FGR and LO‐FGR fetuses had insufficient myocardial maturation. Especially in the LO‐FGR fetuses, TDI is the earliest and most sensitive technique to show subtle changes in fetal cardiac functions.

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Utility of the modified myocardial performance index in growth‐restricted fetuses

Cited by 14 publications

References 42 publications

Turkish reference ranges for the left fetal modified myocardial performance index

Turkish reference ranges for the left fetal modified myocardial performance index

The Prediction of Adverse Perinatal Outcomes in Intrauterine Growth Restriction using the Doppler Indices of Myocardial Performance and Aortic Isthmus

Assessment of fetal cardiac morphology and functional changes in early‐onset and late‐onset fetal growth restriction

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