Left ventricular myocardial performance in the fetus with severe tricuspid valve disease and tricuspid insufficiency.
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.
Inamura
Noboru
N
Department of Pediatric Cardiology, Osaka Medical Center and Research Institute for Maternal and Child Health, Osaka, Japan.
Taketazu
Mio
M
Smallhorn
Jeffrey F
JF
Hornberger
Lisa K
LK
D004437:Ebstein Anomaly / Q000150:complications / Q000503:physiopathology; D015150:Echocardiography, Doppler / Q000379:methods; D005260:Female; D005315:Fetal Diseases / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006349:Heart Valve Diseases / Q000150:complications* / Q000000981:diagnostic imaging / Q000196:embryology*; D006801:Humans; D011247:Pregnancy; D011256:Pregnancy Outcome; D016019:Survival Analysis; D014261:Tricuspid Valve / Q000000981:diagnostic imaging / Q000196:embryology*; D014262:Tricuspid Valve Insufficiency / Q000150:complications / Q000000981:diagnostic imaging; D016216:Ultrasonography, Prenatal / Q000379:methods; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000196:embryology* / Q000209:etiology*