title: Alterations in time intervals of ductus venosus and atrioventricular flow velocity waveforms in growth-restricted fetuses.
abstract: OBJECTIVE
  To investigate time intervals of the ductus venosus (DV) flow velocity waveform (FVW) and those of the cardiac cycle that correspond with each DV-FVW component in fetuses with intrauterine growth restriction (IUGR) due to placental insufficiency.
  
  
  METHODS
  Women with a pregnancy complicated by IUGR were recruited into the study, as was a normal control group. Time intervals for systolic (S) and diastolic (D) components were measured in DV-FVW as follows: S(DV), from the nadir of the a-wave during atrial contraction to the nadir between the S-wave and D-wave; D(DV), from the nadir between S-wave and D-wave to the nadir of the a-wave. Regarding cardiac cycles, the following variables were measured from ventricular inflow through the tricuspid valve (TV) and mitral valve (MV): S(TV) and S(MV), from the second peak of ventricular inflow caused by atrial contraction (A-wave) to the opening of the atrioventricular valve; D(TV) and D(MV), from the opening of the atrioventricular valve to the peak of the A-wave. In the IUGR group, only the last examination performed within 1 week of delivery was used for analysis. All variables were analyzed statistically using Z-scores.
  
  
  RESULTS
  Data were obtained from 249 normal fetuses and 26 fetuses with IUGR. Compared to normal fetuses, S(DV) showed a significant decrease (P < 0.001), while D(DV) showed a significant increase (P < 0.001) in the IUGR group. Regarding cardiac cycles, S(TV) and S(MV) showed significant decreases (P = 0.014 and P < 0.001, respectively) and D(TV) and D(MV) showed significant increases (P = 0.008 and P = 0.002, respectively) in fetuses with IUGR.
  
  
  CONCLUSIONS
  Time-interval alterations of DV-FVW in growth-restricted fetuses reflect the hemodynamic events caused by placental insufficiency.
authors.affiliation: Department of Obstetrics and Gynecology, Osaka City University Graduate School of Medicine, Osaka, Japan.
authors.forename: N
authors.initials: N
authors.lastname: Wada
authors.affiliation: Department of Obstetrics and Gynecology, Osaka City University Graduate School of Medicine, Osaka, Japan.
authors.forename: D
authors.initials: D
authors.lastname: Tachibana
authors.affiliation: Department of Obstetrics and Gynecology, Osaka City University Graduate School of Medicine, Osaka, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Kurihara
authors.affiliation: Department of Obstetrics and Gynecology, Osaka City University Graduate School of Medicine, Osaka, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Nakagawa
authors.affiliation: Department of Obstetrics and Gynecology, Osaka City University Graduate School of Medicine, Osaka, Japan.
authors.forename: A
authors.initials: A
authors.lastname: Nakano
authors.affiliation: Department of Obstetrics and Gynecology, Osaka City University Graduate School of Medicine, Osaka, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Terada
authors.affiliation: Department of Obstetrics and Gynecology, Osaka City General Hospital, Osaka, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Tanaka
authors.affiliation: Laboratory of Statistics, Osaka City University Graduate School of Medicine, Osaka, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Fukui
authors.affiliation: Department of Obstetrics and Gynecology, Osaka City University Graduate School of Medicine, Osaka, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Koyama
authors.affiliation: Department of Obstetrics and Fetal Medicine, University Medical Center, Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: K
authors.initials: K
authors.lastname: Hecher
mesh_terms: D000328:Adult; D001783:Blood Flow Velocity / Q000502:physiology*; D015150:Echocardiography, Doppler / Q000379:methods; D005260:Female; D005317:Fetal Growth Retardation / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005318:Fetal Heart / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005333:Fetus / Q000098:blood supply*; D006801:Humans; D008943:Mitral Valve / Q000000981:diagnostic imaging / Q000503:physiopathology; D010927:Placental Insufficiency / Q000000981:diagnostic imaging / Q000503:physiopathology*; D011247:Pregnancy; D012189:Retrospective Studies; D014261:Tricuspid Valve / Q000000981:diagnostic imaging / Q000503:physiopathology; D016216:Ultrasonography, Prenatal / Q000379:methods; D014469:Umbilical Arteries / Q000000981:diagnostic imaging / Q000503:physiopathology; D014471:Umbilical Veins / Q000000981:diagnostic imaging / Q000503:physiopathology
keywords: Doppler; cardiac cycle; ductus venosus; intrauterine growth restriction; time-related analysis