title: Sequence of changes in myocardial performance index in relation to aortic isthmus and ductus venosus Doppler in fetuses with early-onset intrauterine growth restriction.
abstract: OBJECTIVE
  To explore the sequence of changes in myocardial performance index (MPI) and aortic isthmus (AoI) and ductus venosus (DV) flow in fetuses with early-onset intrauterine growth restriction (IUGR).
  
  
  METHODS
  MPI and AoI and DV pulsatility indices (PI) were evaluated every 1-7 days in a cohort of IUGR fetuses with abnormal umbilical artery Doppler PI (> 95(th) percentile) delivered before 34 weeks' gestation. The longitudinal changes were analyzed in the last 30 days before delivery by multilevel and survival analysis.
  
  
  RESULTS
  A total of 430 scans were performed on 115 IUGR fetuses. MPI, AoI-PI and DV-PI showed increases with the progression of fetal deterioration throughout the follow-up study period, but the rates of progression were different. On average, MPI, AoI-PI and DV-PI crossed the 95(th) percentile at 26 days, 12 days and 5 days before delivery, respectively. At the last examination before delivery, the proportion of increased MPI (70.4%) was significantly higher than that of abnormal AoI-PI (55.7%; P < 0.01) and DV-PI (47.8%; P < 0.01).
  
  
  CONCLUSIONS
  In early-onset IUGR, MPI and AoI and DV Doppler indices all increase but at different rates, which could provide the basis for further research on their use for improving in-utero monitoring and prediction of long-term outcome.
authors.affiliation: Department of Maternal-Fetal Medicine, ICGON, Hospital Clinic-IDIBAPS, University of Barcelona and Centre for Biomedical Research on Rare Diseases (CIBER-ER), Barcelona, Spain.
authors.forename: R
authors.initials: R
authors.lastname: Cruz-Martinez
authors.forename: F
authors.initials: F
authors.lastname: Figueras
authors.forename: A
authors.initials: A
authors.lastname: Benavides-Serralde
authors.forename: F
authors.initials: F
authors.lastname: Crispi
authors.forename: E
authors.initials: E
authors.lastname: Hernandez-Andrade
authors.forename: E
authors.initials: E
authors.lastname: Gratacos
mesh_terms: D000293:Adolescent; D000328:Adult; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging* / Q000196:embryology / Q000503:physiopathology; D001783:Blood Flow Velocity; D005260:Female; D005317:Fetal Growth Retardation / Q000000981:diagnostic imaging*; D005865:Gestational Age; D006334:Heart Function Tests; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D011247:Pregnancy; D011446:Prospective Studies; D012720:Severity of Illness Index; D013030:Spain; D018608:Ultrasonography, Doppler / Q000379:methods; D014471:Umbilical Veins / Q000000981:diagnostic imaging* / Q000196:embryology / Q000503:physiopathology; D055815:Young Adult