Abnormal cardiac function in fetuses with increased nuchal translucency.
OBJECTIVE
To evaluate cardiac function in structurally and chromosomally normal fetuses with increased nuchal translucency (NT).


METHODS
Forty-two structurally and chromosomally normal fetuses with increased NT at 11-14 weeks of gestation underwent fetal echocardiographic examination at 20-23 weeks. Fifty fetuses with normal NT values were considered as controls. Pulmonary and aortic peak velocity and time to peak velocities were measured as indices of ventricular systolic function. The ratios between the E-wave and A-wave (E/A) and the ratios between the E-wave and time velocity integral (E/TVI) at the level of both atrioventricular valves were evaluated as indices of ventricular diastolic function.


RESULTS
In fetuses with increased NT the E/A ratios were significantly decreased when compared to control fetuses at the level of both the mitral (0.52 +/- 0.09 vs. 0.60 +/- 0.10, P = 0.0002) and tricuspid (0.51 +/- 0.09 vs. 0.61 +/- 0.09, P < 0.0001) valves. Similar results were found for the E/TVI ratios (mitral valve 4.79 +/- 1.03 vs. 5.63 +/- 1.23, P = 0.0007 and tricuspid valve 4.40 +/- 0.88 vs. 5.19 +/- 0.82, P < 0.0001). No significant relationship was found between the degree of NT and the abnormalities in Doppler indices. There were no significant differences in Doppler systolic indices.


CONCLUSIONS
Structurally and chromosomally normal fetuses with increased NT have low E/A and E/TVI ratios at 20-23 weeks of gestation. These findings might indicate cardiac diastolic dysfunction.
Rizzo
G
G
Department of Obstetrics and Gynecology, Universita di Roma 'Tor Vergata', Ospedale Fatebenefratelli, Isola Tiberina, Italy. giuseppe.rizzo@uniroma2.it
Muscatello
A
A
Angelini
E
E
Capponi
A
A
D001783:Blood Flow Velocity / Q000502:physiology; D018618:Echocardiography, Doppler, Color / Q000379:methods; D005260:Female; D005315:Fetal Diseases / Q000503:physiopathology*; D005318:Fetal Heart; D005865:Gestational Age; D006331:Heart Diseases / Q000503:physiopathology*; D006801:Humans; D008423:Maternal Age; D008943:Mitral Valve / Q000502:physiology; D009333:Neck / Q000000981:diagnostic imaging / Q000196:embryology; D010298:Parity; D011247:Pregnancy; D014261:Tricuspid Valve / Q000502:physiology; D016216:Ultrasonography, Prenatal / Q000379:methods; D018754:Ventricular Dysfunction / Q000503:physiopathology