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Fetal Myocardial Performance Index

L Guirado, F Crispi, N Masoller, M Bennasar, E Marimon, J Carretero, E Gratacós, J M Martínez, M K Friedberg, O Gómez
OBJECTIVES: to define the pattern of fetal echocardiographic changes associated with isolated pulmonary valve stenosis (PS) and to correlate the echocardiographic findings with the neonatal outcome and the need of postnatal pulmonary valvuloplasty within the first 12 months of life. METHODS: a prospective cohort study was designed on 16 fetuses with isolated PS and 48 controls matched by gestational age at scan (+/- 2 weeks). Fetal standard ultrasound and comprehensive echocardiography, which included cardiovascular morphometric parameters, systolic and diastolic functional and timing-measurements, were performed in all cases...
March 10, 2017: Ultrasound in Obstetrics & Gynecology
Olga Patey, Michael A Gatzoulis, Basky Thilaganathan, Julene S Carvalho
BACKGROUND: The fetal heart at term is exposed to an increase in hemodynamic work as a consequence of fetal growth, increased circulating volume, and alteration in loading patterns due to maturational changes in fetoplacental circulation. The extent to which these cardiovascular changes influence human fetal and neonatal cardiac adaptation has not been fully elucidated. The aim of this study was to evaluate perinatal cardiovascular changes in ventricular geometry and myocardial performance in normal term fetuses...
March 9, 2017: Journal of the American Society of Echocardiography
Ahsan H Khandoker, F Marzbanrad, Y Kimura, Saeed Al Nuaimi, M Palaniswami, Ahsan H Khandoker, F Marzbanrad, Y Kimura, Saeed Al Nuaimi, M Palaniswami, Ahsan H Khandoker, Y Kimura, Saeed Al Nuaimi, F Marzbanrad, M Palaniswami
Doppler-derived myocardial performance index are used to assess aspects of systolic and diastolic function in adult as well as fetal heart. The Tei Index (TI) is a useful and non-invasive tool. The aim of this study was to determine normal values of fetal left ventricular (LV) TI in early (16-32 weeks) and late trimester (35-41 weeks) fetuses and to develop a new myocardial performance index (K-index; KI) which focuses on fetal diastolic interval when oxygenated blood from the placenta filled in the LV. Simultaneous recordings of Doppler Ultrasound Signal (DUS) of the LV outflow tracts and fetal electrocardiogram signals were obtained in 55 early- and late-trimester fetuses...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
I E Bhorat, J S Bagratee, T Reddy
OBJECTIVE: To determine whether fetuses in severe early onset pre-eclampsia (EO-PET) with or without intrauterine growth restriction has cardiac dysfunction across deteriorating stages of placental vascular resistance and whether this dysfunction influences perinatal outcome. STUDY DESIGN: This was a prospective cross-sectional study performed in a tertiary care university medical centre. Sixty pregnant patients with severe early-onset pre-eclampsia between 27 and 32 weeks were recruited and matched with 60 patients having normal pregnancies...
January 16, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Cem Yasar Sanhal, Halil Korkut Daglar, Ozgur Kara, Dilek Uygur, Aykan Yucel
AIM: Fetal cardiac left ventricular function in pregnant women with pregestational or gestational diabetes mellitus was investigated by exploring fetal myocardial performance index (MPI) and E wave/A wave peak velocity (E/A) ratio. METHODS: Seventy pregnant women with either pregestational or gestational diabetes mellitus and with no other systemic or pregnancy related disorders were compared with 70 gestational age matched healthy controls by means of fetal left ventricular MPI and E/A ratio...
November 12, 2016: Journal of Obstetrics and Gynaecology Research
Cenk Gezer, Atalay Ekin, Mehmet Ozeren, Cuneyt Eftal Taner, Emre Mat, Ulas Solmaz
OBJECTIVES: The purpose of this study was to determine whether there are any changes in cardiac function in fetuses with idiopathic polyhydramnios and also to evaluate the value of the myocardial performance index for prediction of adverse perinatal outcomes. METHODS: A prospective case-control study was conducted with a total of 134 fetuses between 24 and 40 weeks' gestation. Polyhydramnios was defined as an amniotic fluid index of greater than 24 cm. Seventy-three fetuses of healthy mothers were assigned as the control group whereas 36 fetuses with an amniotic fluid index of 24 to 34 cm constituted the nonsevere polyhydramnios group, and 31 fetuses with an amniotic fluid index of 35 cm or greater constituted the severe polyhydramnios group...
December 2016: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
A Delabaere, F Leduc, Q Reboul, F Fuchs, S Wavrant, J C Fouron, F Audibert
OBJECTIVES: To determine the prognostic value of fetal Doppler and echocardiographic parameters for neonatal survival up to 30 days after laser coagulation in monochorionic pregnancies complicated by twin-twin transfusion syndrome (TTTS). METHODS: Fetal echocardiography and outcome data of consecutive cases of TTTS treated by laser were retrospectively reviewed. Hemodynamic and cardiac function parameters were collected before and after laser. RESULTS: Between February 2006 and January 2015, 106 fetoscopic laser were performed...
December 2016: Prenatal Diagnosis
Rashmi Pilania, Pooja Sikka, Manoj K Rohit, Vanita Suri, Praveen Kumar
INTRODUCTION: Maternal diabetes mellitus is associated with an increased risk of fetal and neonatal morbidity and mortality. Usual screening tests have not proved to be good prognostic indicators of fetal distress. Fetal cardiodynamics is potentially a useful screening tool. AIM: To determine if cardiodynamics of the fetus differ in pregnancy with diabetes requiring insulin than those without and to determine whether cardiodynamics predict fetal and neonatal outcomes...
July 2016: Journal of Clinical and Diagnostic Research: JCDR
Jan Degenhardt, Christian Enzensberger, Aline Tenzer, Andrea Kawecki, Thomas Kohl, Ellydda Widriani, Roland Axt-Fliedner
Purpose To evaluate pre- and postprocedural myocardial function in fetuses with moderate to severe congenital diaphragmatic hernia (CDH) who underwent FETO to improve survival and to reduce morbidity and to compare these data with fetuses and CDH not undergoing FETO and normal controls. Materials and Methods 8 fetuses with isolated left-sided CDH were included and underwent FETO at our center between 2012 and 2013. Prior to and after the operation, myocardial function was assessed by measuring the mitral annular plane systolic excursion (MAPSE), the tricuspid annular plane systolic excursion (TAPSE), Tei index, isovolumetric contraction time (ICT), ejection time (ET), isovolumetric relaxation time (IRT) for the left ventricle in PW Doppler ultrasound as well as ICT, ET, IRT and Tei index in pulsed wave tissue Doppler imaging (PW-TDI) for the left and right ventricle...
January 2017: Ultraschall in der Medizin
Jiao Chen, Liang Xie, Li Dai, Li Yu, Lijun Liu, Yongbi Zhou, Guiying Wu, Fengfei Qin, Hanmin Liu
The objective of this study was to detect the effect of a large ventricular septal defect (VSD) on right ventricular function before and after birth. All consecutive children with large VSD who were born in our hospital between January 2013-February 2016 and followed up throughout early infancy, and who lacked malformations or chromosomal abnormalities, were identified by a retrospective review of the medical records and included in this retrospective longitudinal case-control study (n = 30). Thirty normal control cases with an equivalent gestational age and gender served as controls...
December 2016: Pediatric Cardiology
Amar Bhide, Olli Vuolteenaho, Mervi Haapsamo, Tiina Erkinaro, Juha Rasanen, Ganesh Acharya
Myocardial performance index (MPI) is increased in growth-restricted fetuses with placental insufficiency, but it is unknown if this is due to fetal hypoxemia or increased placental vascular resistance (Rplac). We used chronically instrumented sheep fetuses (n = 24). In 12 fetuses, placental embolization was performed 24 h before experiments. On the day of the experiment, left (LV) and right (RV) ventricular MPIs were obtained by pulsed Doppler at baseline and in the hypoxemia and recovery phases. At baseline, Rplac was greater and fetal pO2 lower in the placental embolization group, but RV and LV MPIs were comparable to those of the control group...
November 2016: Ultrasound in Medicine & Biology
Warwick B Dunn, J William Allwood, Tim Van Mieghem, R Katie Morris, Fiona L Mackie, Caroline E Fox, Mark D Kilby
INTRODUCTION: Twin-twin transfusion syndrome (TTTS) complicates 15% of monochorionic twin pregnancies, often being associated with recipient cardiac dysfunction. Untreated, it has a fetal mortality rate of at least 90%; although treatment by fetoscopic laser coagulation significantly improves prognosis. Measurement of recipient amniotic fluid metabolites, such as cardiac Troponin T and atrial natriuretic polypeptide, correlate with cardiac function in this fetus. The aim of this study is to describe the amniotic fluid metabolomic profile in TTTS, relate this to fetal recipient cardiac function and assess the metabolomic changes induced by fetoscopic laser coagulation...
August 2016: Placenta
Kasemsri Srisupundit, Fuanglada Tongprasert, Suchaya Luewan, Kuntharee Traisrisilp, Phudit Jatavan, Theera Tongsong
OBJECTIVE: To compare fetal Tei index before, immediately after and 30 min after cordocentesis for prenatal diagnosis. PATIENTS AND METHODS: Pregnant women undergoing prenatal diagnostic cordocentesis in the early mid-trimester underwent measurement of the fetal Tei index of both right and left ventricles just before cordocentesis, immediately after and at 30 min after the procedure. RESULTS: A total of 143 singleton women underwent cordocentesis at a median gestational age of 19 weeks (range 16-23)...
September 2016: Prenatal Diagnosis
P Maheshwari, J Alphonse, A Henry, J Wang, S J Redmond, A Welsh
OBJECTIVES: To determine whether there is beat-to-beat (BTB) variability in the fetal left myocardial performance index (MPI) as evaluated by an automated system, and whether MPI and fetal heart rate (FHR) correlate. METHODS: Prospective cross-sectional study of women at 20-38 weeks gestation with uncomplicated, morphologically normal singleton pregnancies. Multiple cineloops for left MPI measurement were acquired during a single examination in each fetus. Raw cineloop data was analysed by our automated MPI system (ICC of 1...
July 8, 2016: Ultrasound in Obstetrics & Gynecology
Anupama Nair, Sitaraman Radhakrishnan
OBJECTIVE: The aim of this study was to determine normal values for fetal left ventricular (LV)-myocardial performance index (MPI) in Indian population and to assess its relation to advancing gestation and fetal heart rate (FHR). MATERIALS AND METHODS: Two hundred pregnant women without any pregnancy-related complications and whose fetuses were shown to have structurally normal hearts were enrolled in this study. Doppler waveform involving simultaneous display of mitral inflow and LV outflow was obtained in all...
May 2016: Annals of Pediatric Cardiology
Cem Yasar Sanhal, Ozgur Kara, Aykan Yucel
OBJECTIVE: To investigate fetal left ventricular function using the left ventricular modified myocardial performance index (mod-MPI) and E wave/A wave peak velocity (E/A) ratio, and to explore the success of mod-MPI in the prediction of adverse perinatal outcomes in intrahepatic cholestasis of pregnancy (ICP). METHODS: Forty-one ICP cases were compared with 41 gestational age-matched healthy controls. Opening and closing clicks of the mitral and aortic valves were used to define the three time periods [ejection time (ET), isovolumetric contraction time (ICT) and isovolumetric relaxation time (IRT)], which were employed in the calculation of mod-MPI [mod-MPI = (ICT + IRT)/ET]...
June 6, 2016: Journal of Maternal-fetal & Neonatal Medicine
Fatma Nihan Turhan Çağlar, Cem Ozde, Evrim Bostancı, İlker Murat Çağlar, Serkan Çiftçi, İsmail Unğan, Bülent Demir, Osman Karakaya
BACKGROUND: Preeclampsia (PE) is a multisystemic disorder characterized by hypertension and proteinuria that is specific to pregnancy and associated with maternal and fetal morbidity-mortality. AIM: To assess right heart structure and function in PE by echocardiography using conventional and tissue Doppler techniques. METHODS: In total, 67 women with untreated PE and 46 matched healthy pregnant women were included. PE was defined according to the ACOG (2002) criteria...
April 2016: Pregnancy Hypertension
Matthew M Finneran, Ryan Pickens, Megan Templin, Courtney D Stephenson
OBJECTIVE: To validate the efficacy of laser therapy for twin-twin transfusion syndrome (TTTS) in the treatment of recipient twin cardiomyopathy and investigate whether severity of preoperative cardiomyopathy can predict fetal survival postoperatively. STUDY DESIGN: Retrospective study of monochorionic-diamniotic (MCDA) pregnancies complicated by TTTS treated by selective fetoscopic laser photocoagulation (SFLP) performed between March 2010 and October 2014 at a single center...
May 26, 2016: Journal of Maternal-fetal & Neonatal Medicine
Arne Willruth, Johannes Steinhard, Christian Enzensberger, Roland Axt-Fliedner, Ulrich Gembruch, Astrid Doelle, Willem Gorissen, Rolf Fimmers, Franz Bahlmann
PURPOSE: To construct biventricular reference ranges for isovolumic time intervals (isovolumic contraction time, ICT; isovolumic relaxation time, IRT) and ejection time (ET) for colour tissue Doppler imaging (cTDI) between 15 and 37 weeks' in healthy fetuses. METHODS: This was a prospective multicentre cross-sectional study involving 160 singleton pregnancies between 15 and 37 weeks of gestation, using cTDI. ICT, ET, IRT and myocardial performance index (MPI) were analysed offline using a small region of interest (ROI) within the basal part of the right and left ventricular wall immediately distal to the annulus...
November 2016: Archives of Gynecology and Obstetrics
Viola Seravalli, Jena L Miller, Dana Block-Abraham, Ahmet A Baschat
The ductus venosus has a central role in the distribution of highly oxygenated umbilical venous blood to the heart. Its waveform is related to the pressure-volume changes in the cardiac atria and it is therefore important in the monitoring of any fetal condition that may affect forward cardiac function. The cardiovascular parameters that can influence forward cardiac function include afterload, myocardial performance and preload. Decreased forward flow during atrial systole (a-wave) is the most sensitive and ubiquitous finding when any of these parameters is affected...
2016: Acta Obstetricia et Gynecologica Scandinavica
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