title: Correlation between cardiac tissue Doppler and peripheral vascular Doppler in the anemic fetus - an additional method to determine the transfusion threshold?
abstract: OBJECTIVE
  To examine the relationship between cardiac tissue Doppler and peripheral vascular Doppler measurements in fetal anemia.
  
  
  METHODS
  We analyzed high frame rate cardiac Tissue Doppler Imaging (TDI) data files of 26 anemic fetuses. The peak systolic tissue velocity (PSV), peak systolic displacement (PD), and peak systolic strain (PS) were determined in the mid-segment of the ventricular walls (ROI 1 right ventricle (RV), ROI 2 left ventricle (LV)) and in the basal segment of the ventricular walls (ROI 3 tricuspid annulus, ROI 4 mitral annulus). TDI parameters were correlated with established fetal vascular Doppler parameters (peak systolic blood flow velocity (Vmax) in the middle cerebral artery (MCA), pulsatility index (PI) in the MCA, in the umbilical artery (UA), and in the venous duct (DV)).
  
  
  RESULTS
  The PSV in the LV correlated significantly negatively with the PI in the MCA. Both the PSV and PD in the LV correlated significantly negatively with the PI in the UA. The PS in the RV correlated significantly negatively with the PI in the UA. The left ventricular PSV and PD correlated significantly positively with the PI in the DV. The Vmax in the MCA did not correlate with any systolic myocardial TDI parameter.
  
  
  CONCLUSIONS
  In fetal anemia, peak systolic myocardial TDI parameters correlate with vascular Doppler parameters, confirming that TDI is a promising method to evaluate myocardial function in the anemic fetus. This suggests combining both techniques to quantify fetal myocardial function in anemia even more accurately, possibly allowing for the determination of the indication for intrauterine transfusion.
authors: Frauenheilkunde und Geburtshilfe, Fetal Cardiac Imaging Research Group, Westfälische Wilhelms-Universität Münster.
authors: M
authors: M
authors: Michel
authors: Frauenheilkunde und Geburtshilfe, Fetal Cardiac Imaging Research Group, Westfälische Wilhelms-Universität Münster.
authors: R
authors: R
authors: Schmitz
authors: Anästhesiologie und operative Intensivmedizin, Asklepios Klinik Nord, Standort Heidberg, Hamburg.
authors: A
authors: A
authors: Entenmann
authors: Frauenheilkunde und Geburtshilfe, Fetal Cardiac Imaging Research Group, Westfälische Wilhelms-Universität Münster.
authors: J
authors: J
authors: Heinig
authors: Fetale Kardiologie, Zentrum für angeborene Herzfehler, Bad Oeynhausen.
authors: J
authors: J
authors: Steinhard
mesh_terms: D000740:Anemia / Q000000981:diagnostic imaging* / Q000628:therapy*; D001805:Blood Transfusion, Intrauterine; D015150:Echocardiography, Doppler / Q000379:methods*; D005260:Female; D005315:Fetal Diseases / Q000000981:diagnostic imaging*; D006352:Heart Ventricles / Q000000981:diagnostic imaging; D006439:Hemodynamics / Q000502:physiology; D006452:Hemoglobinometry; D006801:Humans; D007231:Infant, Newborn; D010865:Pilot Projects; D011247:Pregnancy; D011446:Prospective Studies; D013223:Statistics as Topic; D018608:Ultrasonography, Doppler / Q000379:methods*; D016216:Ultrasonography, Prenatal / Q000379:methods*