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A comparison of cardiac Z-scores versus cardiac asymmetry for the prenatal screening of congenital heart disease.
MedLine Citation:
PMID:  21400625     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVE: To determine the best screening tests for discriminating early indicators of cardiac hypoplasia in congenital heart disease from normal variation in fetal cardiac growth. METHODS: We retrospectively examined fetal echocardiograms from 90 infants with confirmed congenital heart defects: (Group 1, n = 35) with right-sided obstructive lesions and (Group 2, n = 55) with left-sided obstructive lesions. Our control group was comprised of 2735 normal fetuses, from which we determined fetal cardiac z-scores of right ventricle (RV), left ventricle (LV), aorta (Ao) and pulmonary artery (PA) and ratios of right to left ventricle (RV/LV) and pulmonary artery to aorta (PA/Ao). We compared our normal cohort to Groups 1 and 2, using analysis of variance (ANOVA) and area under the curve (AUC) of receiver operator charteristics (ROC) analysis. RESULTS: For Group 1, RV/LV ratio, RV z-score and PA/Ao ratio were the best screening tests with highest AUC (0.879, 0.868 and 0.832, respectively). For Group 2, the Ao z-score, PA/Ao and RV/LV ratios were the best screening tests with AUC of 0.77, 0.723 and 0.716, respectively. CONCLUSION: None of the screening tests was found to be perfect early discriminators for the cardiac lesions tested. Although ratios of PA/Ao and RV/LV are useful, they should be combined with fetal cardiac z-scores to maximize screening sensitivity. Copyright © 2011 ISUOG. Published by John Wiley & Sons, Ltd.
Authors:
Thomas Riggs; Ashish P Saini; Christine H Comstock; Wesley Lee
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-3-11
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:  -     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-3-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9108340     Medline TA:  Ultrasound Obstet Gynecol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 ISUOG. Published by John Wiley & Sons, Ltd.
Affiliation:
Division of Pediatric Cardiology, Dept. of Pediatrics, Beaumont Children's Hospital, Royal Oak, MI, United States; Research Institute, Beaumont Hospital, Royal Oak, MI, United States. triggs@beaumont.edu.
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