title: Fetal myocardial peak systolic strain before and after intrauterine red blood cell transfusion--a tissue Doppler imaging study.
abstract: OBJECTIVE
  The purpose of this study is to evaluate the cardiac function in anemic fetuses by tissue Doppler imaging (TDI) measuring the myocardial peak systolic strain (PS) in fetuses before and after intrauterine transfusion (IUT) of red blood cells.
  
  
  METHODS
  In our prospective clinical study in anemic fetuses, high-frame-rate TDI data files from a four-chamber view of fetal hearts pre- and post-IUT were analyzed. The biventricular PS parameters of the mid-segment of the ventricular walls [region of interest (ROI) 1 right ventricle, ROI 2 left ventricle] and the basal segment of the ventricular walls (ROI 3 tricuspid annulus, ROI 4 mitral annulus) were compared with the PS data of the normal controls.
  
  
  RESULTS
  We analyzed the pre-/post-data sets from the 15 hearts of anemic fetuses and from the 17 controls. The threshold of statistical significance was set to P≤0.05. Compared with the controls, in anemic fetuses the left ventricular longitudinal myocardial PS (ROI 2, P=0.001) and PS in the basal segment of the right ventricle (ROI 3 P=0.009) was significantly increased (absolute amount). Compared with pre-IUT, post-IUT PS decreased significantly in both ventricles (ROI 1 P=0.025, ROI 2 P=0.02). Compared with the controls, post-IUT left ventricular PS was still higher (absolute amount) (ROI 2, P=0.026; ROI 4, P=0.009).
  
  
  CONCLUSIONS
  The increase in myocardial PS due to severe fetal anemia is partially normalized by IUT. In anemic fetuses, assessment of TDI fetal myocardial PS is feasible.
authors.affiliation: Fetal Cardiac Imaging Research Group, Department of Obstetrics and Gynecology, Westfalian Wilhelms University Münster, Münster, Germany. 4times_M@gmx.de
authors.forename: Miriam
authors.initials: M
authors.lastname: Michel
authors.forename: Ralf
authors.initials: R
authors.lastname: Schmitz
authors.forename: Ludwig
authors.initials: L
authors.lastname: Kiesel
authors.forename: Johannes
authors.initials: J
authors.lastname: Steinhard
mesh_terms: D000740:Anemia / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000628:therapy; D001805:Blood Transfusion, Intrauterine; D016022:Case-Control Studies; D005260:Female; D005315:Fetal Diseases / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000628:therapy; D006321:Heart / Q000503:physiopathology*; D006801:Humans; D011247:Pregnancy; D011446:Prospective Studies; D013599:Systole; D018608:Ultrasonography, Doppler; D016216:Ultrasonography, Prenatal