Fetal Heart Function by Tricuspid Annular Plane Systolic Excursion and Ventricular Shortening Fraction Using STIC M-Mode: Reference Ranges and Validation

Giselle Darahem Tedesco; Marilim de Souza Bezerra; Fernanda Silveira Bello Barros; Wellington P. Martins; Luciano Marcondes Machado Nardozza; Rosiane Mattar; Antonio Fernandes Moron; Liliam Cristine Rolo; Edward Araujo Júnior

doi:10.1055/s-0037-1603652

American Journal of Perinatology, Inhaltsverzeichnis

Am J Perinatol 2017; 34(13): 1354-1361
DOI: 10.1055/s-0037-1603652

Original Article

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Fetal Heart Function by Tricuspid Annular Plane Systolic Excursion and Ventricular Shortening Fraction Using STIC M-Mode: Reference Ranges and Validation

Giselle Darahem Tedesco

¹Department of Obstetrics, Paulista School of Medicine, Federal University of São Paulo (EPM-UNIFESP), São Paulo, SP, Brazil

,

Marilim de Souza Bezerra

¹Department of Obstetrics, Paulista School of Medicine, Federal University of São Paulo (EPM-UNIFESP), São Paulo, SP, Brazil

,

Fernanda Silveira Bello Barros

¹Department of Obstetrics, Paulista School of Medicine, Federal University of São Paulo (EPM-UNIFESP), São Paulo, SP, Brazil

,

Wellington P. Martins

²Department of Gynecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo (FMRP-USP), Ribeirão Preto, São Paulo, SP, Brazil

,

Luciano Marcondes Machado Nardozza

¹Department of Obstetrics, Paulista School of Medicine, Federal University of São Paulo (EPM-UNIFESP), São Paulo, SP, Brazil

,

Rosiane Mattar

¹Department of Obstetrics, Paulista School of Medicine, Federal University of São Paulo (EPM-UNIFESP), São Paulo, SP, Brazil

,

Antonio Fernandes Moron

¹Department of Obstetrics, Paulista School of Medicine, Federal University of São Paulo (EPM-UNIFESP), São Paulo, SP, Brazil

,

Liliam Cristine Rolo

¹Department of Obstetrics, Paulista School of Medicine, Federal University of São Paulo (EPM-UNIFESP), São Paulo, SP, Brazil

,

Edward Araujo Júnior

¹Department of Obstetrics, Paulista School of Medicine, Federal University of São Paulo (EPM-UNIFESP), São Paulo, SP, Brazil

› Institutsangaben

Abstract

Objective To determine the reference values for fetal tricuspid annular plane systolic excursion (f-TAPSE) and fetal ventricular shortening fraction (f-VSF) using spatiotemporal image correlation (STIC) with M-mode, and validate these curves in fetuses of pregnant women with preexisting diabetes mellitus (DM) and with intrauterine growth restriction (IUGR).

Study Design Crosssectional study assessed 300 fetal cardiac volumes of normal pregnancies between 20 and 33 + 6 weeks of gestation. For the construction of the reference curves, we used a polynomial regression model adjusted with the coefficient of determination (R²). For the calculation of reproducibility, the concordance correlation coefficient (CCC) was used.

Results f-TAPSE value correlated with gestational age (GA, R² = 0.46), whereas fetal right ventricular shortening fraction (f-RVSF, R² = 0.02) and fetal left ventricular shortening fraction (f-LVSF, R² = 0.005) did not vary with GA. Fetuses of pregnant women with preexisting DM (30) had lower values of f-RVSF (p = 0.028), f-LVSF (p = 0.001), and f-TAPSE (p = 0.009) than normal fetuses. The f-TAPSE values were lower (p = 0.005) in IUGR group (17). The f-TASPSE values showed adequate reliability as well as good intra and interobserver concordance (CCC = 0.95 and 0.79, respectively).

Conclusion The reference ranges for f-TAPSE, f-RVSF, and f-LVSF using the STIC M-mode were established and had good reproducibility for f-TAPSE measurements.

Keywords

reference ranges - fetal heart function - tricuspid annular plane systolic excursion - ventricular shortening fraction - M-mode - three-dimensional ultrasound

Volltext

Referenzen

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