Document Detail

Myocardial tissue Doppler assessment of diastolic function in the growth-restricted fetus.
MedLine Citation:
PMID:  19565528     Owner:  NLM     Status:  In-Process    
OBJECTIVES: Myocardial tissue Doppler (MTD) is a technique for the measurement of myocardial velocities in systole and diastole. This study evaluates the use of MTD in the assessment of cardiac diastolic function in fetuses with intrauterine growth restriction (IUGR) with placental insufficiency and in appropriate-for-gestational age (AGA) fetuses with hypertensive mothers. METHODS: This study included 14 IUGR fetuses with placental insufficiency (Group 1), 13 AGA fetuses with hypertensive mothers (Group 2), and 29 AGA fetuses with healthy mothers (Group 3). Patients with other diseases were excluded. All fetuses had a gestational age of at least 25 weeks. MTD assessment was performed with the sample volume placed at the basal segment of the left ventricular side wall (LV), the interventricular septum (IVS) and the right ventricular free wall (RV). E'/A' ratios were calculated for each location. Mitral and tricuspid flows were assessed by conventional spectral pulsed Doppler. RESULTS: Significant differences were found between groups for E'/A' at the IVS (P < 0.001) and LV (P = 0.009), with a higher mean (+/- SD) value in Group 1 (IVS: 0.92 +/- 0.28; LV: 0.85 +/- 0.19) than in Groups 2 (IVS: 0.62 +/- 0.09; LV: 0.68 +/- 0.14) and 3 (IVS: 0.71 +/- 0.14; LV: 0.69 +/- 0.15). In the RV, there was no statistically significant difference in the E'/A' ratio (P = 0.2). No differences were observed for mitral and tricuspid flow velocities and ratios. CONCLUSIONS: Using MTD, the ratios between early and late diastolic myocardial velocities are higher in IUGR fetuses than in AGA fetuses at the IVS and the LV, regardless of the presence of maternal hypertension. MTD may be more sensitive than atrioventricular spectral Doppler for the detection of ventricular diastolic dysfunction in IUGR fetuses.
A A Naujorks; P Zielinsky; P A Beltrame; R C Castagna; R Petracco; A Busato; A L H Nicoloso; A Piccoli; J L Manica
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology     Volume:  34     ISSN:  1469-0705     ISO Abbreviation:  Ultrasound Obstet Gynecol     Publication Date:  2009 Jul 
Date Detail:
Created Date:  2009-07-06     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9108340     Medline TA:  Ultrasound Obstet Gynecol     Country:  England    
Other Details:
Languages:  eng     Pagination:  68-73     Citation Subset:  IM    
Copyright Information:
(c) 2009 ISUOG.
Fetal Cardiology Unit, Institute of Cardiology of Rio Grande do Sul, Porto Alegre, Brazil.
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