Left Ventricular Myocardial Performance in the Fetus with Severe Tricuspid Valve Disease and Tricuspid Insufficiency

Noboru Inamura; Mio Taketazu; Jeffrey F. Smallhorn; Lisa K. Hornberger

doi:10.1055/s-2005-837739

American Journal of Perinatology, Table of Contents

Am J Perinatol 2005; 22(2): 91-97
DOI: 10.1055/s-2005-837739

Left Ventricular Myocardial Performance in the Fetus with Severe Tricuspid Valve Disease and Tricuspid Insufficiency

Noboru Inamura¹ , Mio Taketazu² , Jeffrey F. Smallhorn² , Lisa K. Hornberger²

¹Department of Pediatric Cardiology, Osaka Medical Center and Research Institute for Maternal and Child Health, Osaka, Japan
²Fetal Cardiac Program, Division of Cardiology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Ontario, Canada

Abstract

ABSTRACT

We sought to determine whether left ventricular (LV) function is abnormal in a fetus with severe tricuspid valve disease (TVD), and whether it may contribute to the outcome. We measured the LV Tei index (including isovolumic relaxation [IRT], contraction, and ejection times) in 31 fetuses with TVD, compared the data with measurements from 32 normal fetuses, and correlated these measurements with pulmonary morphology and outcome. LV Tei index was significantly greater, ejection times shorter, and IRT longer in TVD compared with controls. The Tei index was highest in fetuses with either pulmonary insufficiency or atresia compared with those with forward flow. Finally, LV Tei index was significantly greater in fetuses with fetal (n = 5) or neonatal (n = 9) demise than in neonatal survivors (n = 7). Global LV performance as assessed by the Tei index is abnormal in TVD and likely contribute to the high mortality associated with TVD.

KEYWORDS

Tricuspid valve disease - fetal echocardiography - Tei index, hydrops fetalis

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References

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Noboru InamuraM.D.

Department of Pediatric Cardiology, Osaka Medical Center and Research Institute for Maternal and Child Health

840 Murodo-cho, Izumi, Osaka 594-1101, Japan