Multimedialna platforma wiedzy medycznej Internetowa Księgarnia Medyczna Kalendarium Konferencji
Ginekologia Polska
MENU
Shortcuts Submit an article Author Guidelines Ahead Of Print Reviewers 2023

open access

Vol 92, No 3 (2021)
Research paper
Published online: 2021-02-23
View PDF Download PDF file
Get Citation

Investigation of fetal cardiac function using tissue doppler imaging in fetuses compromised by growth restriction

Rabia Merve Palalioglu1, Halil Ibrahim Erbiyik2, Basak Kaya3, Huseyin Kiyak3, Ali Gedikbasi3
DOI: 10.5603/GP.a2020.0175
·
Pubmed: 33751512
·
Ginekol Pol 2021;92(3):195-204.
Affiliations
  1. Department of Obstetrics and Gynecology, University of Health Sciences, Umraniye Training and Research Hospital, Elmalıkent Mah. Adem Yavuz Cad. Trt Sok. Umraniye, Istanbul, Turkey
  2. Uskudar University, Istanbul, Türkiye
  3. Department of Obstetrics and Gynecology, Saglik Bilimleri University, Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Türkiye

open access

Vol 92, No 3 (2021)
ORIGINAL PAPERS Obstetrics
Published online: 2021-02-23

Abstract

Objectives: The primary aim of this study was to evaluate fetal cardiac systolic and diastolic function using the tissue Doppler
technique in pregnancies with complications of fetal growth restriction (FGR) and to examine the relationship between
FGR with umbilical artery Doppler parameters and fetal cardiac function in complicated pregnancies.
Material and methods: This study included 30 pregnant women with FGR complications and 46 pregnant women without
FGR complications. Both groups were at 24–34 gestational weeks. Fetal cardiac examination was performed using pulsed
Doppler and tissue Doppler imaging (TDI) in all pregnancies. In the analysis of myocardial tissue by tissue Doppler, the
tracing obtained from the junction of the tricuspid valve annulus with the right ventricle was recorded by measuring the
duration of the isovolumetric contraction wave (IVC), ejection time (ET), and isovolumetric relaxation time (IVR). Furthermore,
we calculated the myocardial performance index (MPI) and then measured and recorded the early diastolic annular rate.
Results: Based on the TDI studies, the mean IVC and IVR values were significantly longer and the ET values were significantly
shorter in the study group than those in the control group. The study group also had significantly longer MPI measurements.
Conclusions: Because TDI is a considerably more sensitive method than cardiac sonographic evaluation using pulsed
Doppler, tissue Doppler parameters facilitate the detection of cardiac dysfunction at a relatively early stage. In addition,
TDI and myocardial evaluation in fetuses with FGR can be noninvasively performed in clinical practice.

Abstract

Objectives: The primary aim of this study was to evaluate fetal cardiac systolic and diastolic function using the tissue Doppler
technique in pregnancies with complications of fetal growth restriction (FGR) and to examine the relationship between
FGR with umbilical artery Doppler parameters and fetal cardiac function in complicated pregnancies.
Material and methods: This study included 30 pregnant women with FGR complications and 46 pregnant women without
FGR complications. Both groups were at 24–34 gestational weeks. Fetal cardiac examination was performed using pulsed
Doppler and tissue Doppler imaging (TDI) in all pregnancies. In the analysis of myocardial tissue by tissue Doppler, the
tracing obtained from the junction of the tricuspid valve annulus with the right ventricle was recorded by measuring the
duration of the isovolumetric contraction wave (IVC), ejection time (ET), and isovolumetric relaxation time (IVR). Furthermore,
we calculated the myocardial performance index (MPI) and then measured and recorded the early diastolic annular rate.
Results: Based on the TDI studies, the mean IVC and IVR values were significantly longer and the ET values were significantly
shorter in the study group than those in the control group. The study group also had significantly longer MPI measurements.
Conclusions: Because TDI is a considerably more sensitive method than cardiac sonographic evaluation using pulsed
Doppler, tissue Doppler parameters facilitate the detection of cardiac dysfunction at a relatively early stage. In addition,
TDI and myocardial evaluation in fetuses with FGR can be noninvasively performed in clinical practice.

Full Text:

View PDF Download PDF file
Get Citation

Keywords

fetal cardiac function; FGR; myocardial performance index; tissue Doppler imaging

About this article
Title

Investigation of fetal cardiac function using tissue doppler imaging in fetuses compromised by growth restriction

Journal

Ginekologia Polska

Issue

Vol 92, No 3 (2021)

Article type

Research paper

Pages

195-204

Published online

2021-02-23

Page views

941

Article views/downloads

984

DOI

10.5603/GP.a2020.0175

Pubmed

33751512

Bibliographic record

Ginekol Pol 2021;92(3):195-204.

Keywords

fetal cardiac function
FGR
myocardial performance index
tissue Doppler imaging

Authors

Rabia Merve Palalioglu
Halil Ibrahim Erbiyik
Basak Kaya
Huseyin Kiyak
Ali Gedikbasi

References (32)
  1. Lausman A, Kingdom J, Gagnon R, et al. Intrauterine Growth Restriction: Screening, Diagnosis, and Management. J Obstet Gynaecol Can. 2013; 35(8): 741–748.
    CrossRef
  2. ACOG Practice bulletin no. 134: fetal growth restriction. Obstet Gynecol. 2013; 121(5): 1122–1133.
    CrossRefPubMed
  3. Barker DJ, Winter PD, Osmond C, et al. Weight in infancy and death from ischaemic heart disease. Lancet. 1989; 2(8663): 577–580.
    CrossRefPubMed
  4. Barker DJ, Osmond C, Simmonds SJ, et al. The relation of small head circumference and thinness at birth to death from cardiovascular disease in adult life. BMJ. 1993; 306(6875): 422–426.
    CrossRefPubMed
  5. Salafia CM, Charles AK, Maas EM. Placenta and fetal growth restriction. Clin Obstet Gynecol. 2006; 49(2): 236–256.
    CrossRefPubMed
  6. Haram K, Søfteland E, Bukowski R, et al. Intrauterine growth restriction. Int J Gynaecol Obstet. 2006; 93(1): 5–12.
    CrossRefPubMed
  7. Figueras F, Puerto B, Martinez JM, et al. Cardiac function monitoring of fetuses with growth restriction. Eur J Obstet Gynecol Reprod Biol. 2003; 110(2): 159–163.
    CrossRefPubMed
  8. Crispi F, Hernandez-Andrade E, Pelsers MM, et al. Cardiac dysfunction and cell damage across clinical stages of severity in growth-restricted fetuses. Am J Obstet Gynecol. 2008; 199(3): 254.e1–254.e8.
    CrossRefPubMed
  9. Girsen A, Ala-Kopsala M, Mäkikallio K, et al. Cardiovascular hemodynamics and umbilical artery N-terminal peptide of proB-type natriuretic peptide in human fetuses with growth restriction. Ultrasound Obstet Gynecol. 2007; 29(3): 296–303.
    CrossRefPubMed
  10. Mäkikallio K, Vuolteenaho O, Jouppila P, et al. Ultrasonographic and biochemical markers of human fetal cardiac dysfunction in placental insufficiency. Circulation. 2002; 105(17): 2058–2063.
    CrossRefPubMed
  11. Watanabe S, Hashimoto I, Saito K, et al. Characterization of ventricular myocardial performance in the fetus by tissue Doppler imaging. Circ J. 2009; 73(5): 943–947.
    CrossRefPubMed
  12. DeVore GR. Assessing fetal cardiac ventricular function. Semin Fetal Neonatal Med. 2005; 10(6): 515–541.
    CrossRefPubMed
  13. Hernandez-Andrade E, López-Tenorio J, Figueroa-Diesel H, et al. A modified myocardial performance (Tei) index based on the use of valve clicks improves reproducibility of fetal left cardiac function assessment. Ultrasound Obstet Gynecol. 2005; 26(3): 227–232.
    CrossRefPubMed
  14. Bilardo CM, Wolf H, Stigter RH, et al. Relationship between monitoring parameters and perinatal outcome in severe, early intrauterine growth restriction. Ultrasound Obstet Gynecol. 2004; 23(2): 119–125.
    CrossRefPubMed
  15. Seckl JR, Meaney MJ. Glucocorticoid "programming" and PTSD risk. Ann N Y Acad Sci. 2006; 1071: 351–378.
    CrossRefPubMed
  16. Vickers MH, Gluckman PD, Coveny AH, et al. Neonatal leptin treatment reverses developmental programming. Endocrinology. 2005; 146(10): 4211–4216.
    CrossRefPubMed
  17. Crispi F, Bijnens B, Figueras F, et al. Fetal growth restriction results in remodeled and less efficient hearts in children. Circulation. 2010; 121(22): 2427–2436.
    CrossRefPubMed
  18. Kiserud T, Ebbing C, Kessler J, et al. Fetal cardiac output, distribution to the placenta and impact of placental compromise. Ultrasound Obstet Gynecol. 2006; 28(2): 126–136.
    CrossRefPubMed
  19. Tsyvian P, Malkin K, Wladimiroff JW. Assessment of fetal left cardiac isovolumic relaxation time in appropriate and small-for-gestational-age fetuses. Ultrasound Med Biol. 1995; 21(6): 739–743.
    CrossRefPubMed
  20. Tsyvian P, Malkin K, Artemieva O, et al. Cardiac ventricular performance in the appropriate- for-gestational age and small-for-gestational age fetus: relation to regional cardiac non-uniformity and peripheral resistance. Ultrasound Obstet Gynecol. 2002; 20(1): 35–41.
    CrossRefPubMed
  21. Chaiworapongsa T, Espinoza J, Yoshimatsu J, et al. Subclinical myocardial injury in small-for-gestational-age neonates. J Matern Fetal Neonatal Med. 2002; 11(6): 385–390.
    CrossRefPubMed
  22. Baschat AA, Cosmi E, Bilardo CM, et al. Predictors of neonatal outcome in early-onset placental dysfunction. Obstet Gynecol. 2007; 109(2 Pt 1): 253–261.
    CrossRefPubMed
  23. Schwarze A, Gembruch U, Krapp M, et al. Qualitative venous Doppler flow waveform analysis in preterm intrauterine growth-restricted fetuses with ARED flow in the umbilical artery--correlation with short-term outcome. Ultrasound Obstet Gynecol. 2005; 25(6): 573–579.
    CrossRefPubMed
  24. Ichizuka K, Matsuoka R, Hasegawa J, et al. The Tei index for evaluation of fetal myocardial performance in sick fetuses. Early Hum Dev. 2005; 81(3): 273–279.
    CrossRefPubMed
  25. Berkley E, Chauhan SP, Abuhamad A. Society for Maternal-Fetal Medicine Publications Committee. Doppler assessment of the fetus with intrauterine growth restriction. Am J Obstet Gynecol. 2012; 206(4): 300–308.
    CrossRefPubMed
  26. Ho CY, Solomon SD. A clinician's guide to tissue Doppler imaging. Circulation. 2006; 113(10): e396–e398.
    CrossRefPubMed
  27. Chan LYs, Fok WY, Wong JTh, et al. Reference charts of gestation-specific tissue Doppler imaging indices of systolic and diastolic functions in the normal fetal heart. Am Heart J. 2005; 150(4): 750–755.
    CrossRefPubMed
  28. Kaya B, Tayyar A, Açar DK, et al. Comparison of fetal cardiac functions between small-for-gestational age fetuses and late-onset growth-restricted fetuses. J Perinat Med. 2019; 47(8): 879–884.
    CrossRefPubMed
  29. Alici Davutoglu E, Ozel A, Oztunc F, et al. Modified myocardial performance index and its prognostic significance for adverse perinatal outcome in early and late onset fetal growth restriction. J Matern Fetal Neonatal Med. 2020; 33(2): 277–282.
    CrossRefPubMed
  30. Pérez-Cruz M, Cruz-Lemini M, Fernández MT, et al. Fetal cardiac function in late-onset intrauterine growth restriction vs small-for-gestational age, as defined by estimated fetal weight, cerebroplacental ratio and uterine artery Doppler. Ultrasound Obstet Gynecol. 2015; 46(4): 465–471.
    CrossRefPubMed
  31. Figueras F, Gratacós E. Update on the diagnosis and classification of fetal growth restriction and proposal of a stage-based management protocol. Fetal Diagn Ther. 2014; 36(2): 86–98.
    CrossRefPubMed
  32. Schulman H, Fleischer A, Farmakides G, et al. Development of uterine artery compliance in pregnancy as detected by Doppler ultrasound. Am J Obstet Gynecol. 1986; 155(5): 1031–1036.
    CrossRef

Regulations

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

By VM Media Group sp. z o.o., ul. Świętokrzyska 73, 80–180 Gdańsk
tel.:+48 58 320 94 94, faks:+48 58 320 94 60, e-mail:  viamedica@viamedica.pl