title: Fetal ventricular interactions and wall mechanics during ductus arteriosus occlusion in a sheep model.
abstract: We investigated the effect of fetal sheep ductus arteriosus occlusion (DO) on the distribution of cardiac output and left and right ventricular function by tissue and pulsed Doppler at baseline; after 15 and 60 min of DO induced with a vascular occluder; and 15 min after release of DO. Ductal occlusion decreased fetal pO2. Mean left ventricular output increased (p < 0.001) from 725 to 1013 mL/min, and right ventricular (1185 mL/min vs. 552 mL/min) and systemic (1757 mL/min vs. 1013 mL/min) cardiac outputs fell (p < 0.001) after 15 min of DO, compared with baseline. Pulmonary vascular impedance decreased and volume blood flow increased more than threefold during DO, whereas foramen ovale volume blood flow remained unchanged. Left ventricular systolic function was unaffected, whereas isovolumic relaxation velocity deceleration decreased. Right ventricular functional indices remained unchanged. We conclude that DO increased pulmonary volume blood flow, not foramen ovale volume blood flow. Left ventricular output increased, although not as much as right ventricular output fell, resulting in decreased systemic cardiac output. During DO, left ventricular function exhibited diminished relaxation.
authors.affiliation: Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Oregon Health & Science University, Portland, Oregon, USA.
authors.forename: Jason N
authors.initials: JN
authors.lastname: Hashima
authors.affiliation: Division of Cardiothoracic Surgery, Department of Surgery, Oregon Health & Science University, Portland, Oregon, USA.
authors.forename: Vanessa
authors.initials: V
authors.lastname: Rogers
authors.affiliation: Division of Cardiothoracic Surgery, Department of Surgery, Oregon Health & Science University, Portland, Oregon, USA.
authors.forename: Stephen M
authors.initials: SM
authors.lastname: Langley
authors.affiliation: Division of Pediatric Cardiology, Department of Pediatrics, Oregon Health & Science University, Portland, Oregon, USA.
authors.forename: Muhammed
authors.initials: M
authors.lastname: Ashraf
authors.affiliation: Division of Pediatric Cardiology, Department of Pediatrics, Oregon Health & Science University, Portland, Oregon, USA.
authors.forename: David J
authors.initials: DJ
authors.lastname: Sahn
authors.affiliation: Department of Anesthesiology and Surgery, Oulu University Hospital, Oulu, Finland.
authors.forename: Pasi
authors.initials: P
authors.lastname: Ohtonen
authors.affiliation: Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Oregon Health & Science University, Portland, Oregon, USA.
authors.forename: Lowell E
authors.initials: LE
authors.lastname: Davis
authors.affiliation: Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Oregon Health & Science University, Portland, Oregon, USA.
authors.forename: A Roger
authors.initials: AR
authors.lastname: Hohimer
authors.affiliation: Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Oregon Health & Science University, Portland, Oregon, USA; Department of Obstetrics and Gynecology, Oulu University Hospital, Oulu, Finland; Department of Obstetrics and Gynecology, Kuopio University Hospital and University of Eastern Finland, Kuopio, Finland. Electronic address: juha.rasanen@oulu.fi.
authors.forename: Juha
authors.initials: J
authors.lastname: Rasanen
mesh_terms: D000818:Animals; D002302:Cardiac Output / Q000502:physiology; D003251:Constriction, Pathologic; D004195:Disease Models, Animal; D004373:Ductus Arteriosus / Q000000981:diagnostic imaging* / Q000503:physiopathology; D015150:Echocardiography, Doppler; D005260:Female; D005318:Fetal Heart / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006352:Heart Ventricles / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology; D011247:Pregnancy; D012756:Sheep; D018754:Ventricular Dysfunction / Q000000981:diagnostic imaging* / Q000503:physiopathology
keywords: Echocardiography; Hemodynamics; Imaging; Pregnancy; Regional blood flow