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Quantitative assessment of right ventricular function using doppler tissue imaging in fetuses with and without heart failure.
J Am Soc Echocardiogr. 2004 Jan; 17(1):28-35.JA

Abstract

BACKGROUND

Previous reports have established the use of Doppler tissue imaging (DTI) for noninvasive assessment of ventricular function, but the technique has not been validated for diagnosis of fetal cardiac failure.

OBJECTIVE

The purpose of this study was to assess right ventricular (RV) function in fetuses with heart failure using DTI.

METHODS

In all, 43 fetuses (36 control, 7 heart failure) were assessed using pulsed Doppler echocardiography combined with DTI. RV peak myocardial velocities during early diastole (Ea), atrial contraction, and systole were measured; and tricuspid peak velocities during early diastole (E) and atrial contraction. The ratio of E/Ea was used as an index of filling pressure were measured. From DTI, a Doppler-derived index of combined systolic/diastolic myocardial performance (DTI-Tei index) was measured.

RESULTS

Compared with control fetuses, the mean Ea was significantly lower and the mean E was significantly higher in fetuses with heart failure, although these parameters did overlap between the 2 groups. The mean RV myocardial wall-motion velocity during atrial contraction, ratio of Ea/RV myocardial wall-motion velocity during atrial contraction, and RV myocardial wall-motion velocity during systole did not differ between the 2 groups. Compared with control fetuses, the mean E/Ea was significantly higher (9.71 +/- 0.91 vs 6.20 +/- 0.97; P <.0001) and the mean DTI-Tei index was significantly greater (0.79 +/- 0.11 vs 0.55 +/- 0.05; P <.0001) in fetuses with heart failure. In addition, the DTI-Tei index z score was >2 in all fetuses with heart failure.

CONCLUSIONS

This study demonstrated a clinically important application of DTI-derived tricuspid annular velocities in fetuses with heart failure. Although DTI velocities were not sufficiently sensitive to identify fetuses with heart failure versus control fetuses, DTI-Tei index and E/Ea were useful and sensitive indicators of global RV dysfunction.

Authors+Show Affiliations

Department of Pediatrics, Department of Obstetrics and Gynecology, Akita University School of Medicine, Akita, Japan.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Evaluation Study
Journal Article

Language

eng

PubMed ID

14712184

Citation

Aoki, Mieko, et al. "Quantitative Assessment of Right Ventricular Function Using Doppler Tissue Imaging in Fetuses With and Without Heart Failure." Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography, vol. 17, no. 1, 2004, pp. 28-35.
Aoki M, Harada K, Ogawa M, et al. Quantitative assessment of right ventricular function using doppler tissue imaging in fetuses with and without heart failure. J Am Soc Echocardiogr. 2004;17(1):28-35.
Aoki, M., Harada, K., Ogawa, M., & Tanaka, T. (2004). Quantitative assessment of right ventricular function using doppler tissue imaging in fetuses with and without heart failure. Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography, 17(1), 28-35.
Aoki M, et al. Quantitative Assessment of Right Ventricular Function Using Doppler Tissue Imaging in Fetuses With and Without Heart Failure. J Am Soc Echocardiogr. 2004;17(1):28-35. PubMed PMID: 14712184.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Quantitative assessment of right ventricular function using doppler tissue imaging in fetuses with and without heart failure. AU - Aoki,Mieko, AU - Harada,Kenji, AU - Ogawa,Masaki, AU - Tanaka,Toshinobu, PY - 2004/1/9/pubmed PY - 2004/4/24/medline PY - 2004/1/9/entrez SP - 28 EP - 35 JF - Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography JO - J Am Soc Echocardiogr VL - 17 IS - 1 N2 - BACKGROUND: Previous reports have established the use of Doppler tissue imaging (DTI) for noninvasive assessment of ventricular function, but the technique has not been validated for diagnosis of fetal cardiac failure. OBJECTIVE: The purpose of this study was to assess right ventricular (RV) function in fetuses with heart failure using DTI. METHODS: In all, 43 fetuses (36 control, 7 heart failure) were assessed using pulsed Doppler echocardiography combined with DTI. RV peak myocardial velocities during early diastole (Ea), atrial contraction, and systole were measured; and tricuspid peak velocities during early diastole (E) and atrial contraction. The ratio of E/Ea was used as an index of filling pressure were measured. From DTI, a Doppler-derived index of combined systolic/diastolic myocardial performance (DTI-Tei index) was measured. RESULTS: Compared with control fetuses, the mean Ea was significantly lower and the mean E was significantly higher in fetuses with heart failure, although these parameters did overlap between the 2 groups. The mean RV myocardial wall-motion velocity during atrial contraction, ratio of Ea/RV myocardial wall-motion velocity during atrial contraction, and RV myocardial wall-motion velocity during systole did not differ between the 2 groups. Compared with control fetuses, the mean E/Ea was significantly higher (9.71 +/- 0.91 vs 6.20 +/- 0.97; P <.0001) and the mean DTI-Tei index was significantly greater (0.79 +/- 0.11 vs 0.55 +/- 0.05; P <.0001) in fetuses with heart failure. In addition, the DTI-Tei index z score was >2 in all fetuses with heart failure. CONCLUSIONS: This study demonstrated a clinically important application of DTI-derived tricuspid annular velocities in fetuses with heart failure. Although DTI velocities were not sufficiently sensitive to identify fetuses with heart failure versus control fetuses, DTI-Tei index and E/Ea were useful and sensitive indicators of global RV dysfunction. SN - 0894-7317 UR - https://www.unboundmedicine.com/medline/citation/14712184/Quantitative_assessment_of_right_ventricular_function_using_doppler_tissue_imaging_in_fetuses_with_and_without_heart_failure_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0894731703008125 DB - PRIME DP - Unbound Medicine ER -