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Evaluation of right ventricular function in the fetus with hypoplastic left heart using tissue Doppler techniques.
MedLine Citation:
PMID:  25418127     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVE: The outcome of patients with HLH is influenced by right ventricular function. The study aimed to investigate, whether differences in right ventricular function of fetuses with HLH may be present during gestation.
METHODS: Prospective study of 14 fetuses with HLH (28 measurements) and 28 normal controls (31 measurements). The two groups were adjusted for gestational age. M-Mode was used for assessment of annular displacement of the tricuspid annulus. Spectral Doppler and myocardial tissue Doppler derived inflow and outflow velocities were assessed. E/A and E/E'ratios as well as the tissue Doppler derived myocardial performance index were calculated.
RESULTS: In HLH fetuses there was a higher E velocity (mean 40.14 cm/s vs. 35.47 cm/s; p < 0.05, respectively). A velocity showed a tendency to higher values in the right ventricle compared to normal controls, but this did not reach statistical significance (61.16 cm/s vs. 54.64 cm/s, p = 0,08). In controls but not in HLH fetuses the E/A ratio increased over gestation. Peak A' velocity was significantly lower in controls than in HLH fetuses (9.50 cm/s vs. 10.39 cm/s, p < 0.05). The E/E' ratio was significantly lower in controls than in HLH fetuses (5.77 vs. 7.37, p < 0.05). Values for right ventricular MPI and TAPSE did not show differences among both groups.
CONCLUSION: The results show that an altered right ventricular function in HLH fetuses might begin antenatally. Confirmation of these findings with Doppler independent techniques will hopefully allow further exploration of ventricular function in HLH fetuses. By this, parental counseling and postnatal management strategies could be influenced.
Authors:
Roland Axt-Fliedner; Oliver Graupner; Jan Degenhardt; Johannes Herrmann; Aline Tenzer; Astrid Doelle; Christian Enzensberger
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-11-24
Journal Detail:
Title:  Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology     Volume:  -     ISSN:  1469-0705     ISO Abbreviation:  Ultrasound Obstet Gynecol     Publication Date:  2014 Nov 
Date Detail:
Created Date:  2014-11-24     Completed Date:  -     Revised Date:  2014-11-25    
Medline Journal Info:
Nlm Unique ID:  9108340     Medline TA:  Ultrasound Obstet Gynecol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
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This article is protected by copyright. All rights reserved.
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