title: Cerebral vascular resistance and left ventricular myocardial performance in fetuses with Ebstein's anomaly.
abstract: We sought to determine whether cerebral vascular resistance and left ventricular myocardial performance (LVTei) are abnormal in fetuses with Ebstein's anomaly. The pulsatility index of the middle cerebral artery (MCAPI) and umbilical artery (UAPI), LVTei, left ventricular ejection fraction (LVEF), and fetal cardiovascular profile score in 11 fetuses with Ebstein's anomaly were evaluated by fetal echocardiography. MCAPI/UAPI values were calculated for the Ebstein's anomaly group. The control group included 44 healthy fetuses of uncomplicated pregnancies matched for gestational age (according to 1:4). MCAPI and MCAPI/UAPI were significantly lower in fetuses with Ebstein's anomaly than in controls (all P < 0.001). UAPI and LVTei were higher in fetuses with Ebstein's anomaly than in control fetuses ( P < 0.001, P < 0.05, respectively). No significant between group difference was observed for LVEF ( P > 0.05). The median cardiovascular profile score (CVPS) for the fetuses with Ebstein's anomaly (median, 7.0; interquartile range [IQR], 5.0 to 8.0) was a full point lower than for controls (median, 10.0; IQR 10.0 to 10.0). This difference was statistically significant ( P < 0.001). MCAPI and LVTei were both correlated with fetal CVPS in fetuses with Ebstein's anomaly (correlation coefficient (1) = 0.477, P < 0.05; correlation coefficient (2) = -0.602, P < 0.05). In fetuses with Ebstein's anomaly in utero, cerebral vascular resistance is decreased; global LV performance, as assessed by the Tei index, is abnormal.
authors.affiliation: Department of Ultrasound, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China.
authors.forename: Youfang
authors.initials: Y
authors.lastname: Chen
authors.forename: Guorong
authors.initials: G
authors.lastname: Lv
authors.forename: Boyi
authors.initials: B
authors.lastname: Li
authors.forename: Zhenhua
authors.initials: Z
authors.lastname: Wang
mesh_terms: D016022:Case-Control Studies; D002560:Cerebrovascular Circulation / Q000502:physiology*; D004437:Ebstein Anomaly / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D018618:Echocardiography, Doppler, Color; D005260:Female; D005333:Fetus / Q000098:blood supply / Q000503:physiopathology; D005865:Gestational Age; D006801:Humans; D008297:Male; D020768:Middle Cerebral Artery; D011247:Pregnancy; D011256:Pregnancy Outcome; D011296:Prenatal Diagnosis / Q000379:methods; D011336:Probability; D011673:Pulsatile Flow; D012189:Retrospective Studies; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D013318:Stroke Volume; D016216:Ultrasonography, Prenatal; D014469:Umbilical Arteries; D014655:Vascular Resistance / Q000502:physiology*; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000503:physiopathology*