title: Ventricular Diastolic Function in Normal Fetuses and Fetuses with Hb Bart's Disease Assessed by Color M-Mode Propagation Velocity using Cardio-STIC-M (Spatio-Temporal Image Correlation M-Mode).
abstract: Purpose:To determine whether ventricular diastolic dysfunction contributes to the pathogenesis of fetal cardiac failure due to fetal anemia using fetal Hb Bart's disease as a live model and cardio-STIC-M as a diagnostic tool.Materials and Methods:Color cardio-STIC volume datasets were acquired from fetuses at risk for Hb Bart's disease during 18 - 22 weeks of gestation and normal pregnancies and pregnancies with hydrops fetalis caused by Hb Bart's disease at 28 - 32 weeks. The volumes were analyzed off-line for velocity propagation (Vp) of the right and left ventricles to assess ventricular diastolic function using color cardio-STIC-M.Results:The Vp for the right and left ventricles was studied in fetuses at 18 - 22 weeks, including 64 normal fetuses (group 1) and 22 fetuses with Hb Bart's disease (group 2), and in fetuses at 28 - 32 weeks, including 22 normal fetuses (group 3) and 16 fetuses with Hb Bart's hydrops fetalis (group 4). The Vp of the fetuses in group 1 and group 2 was not significantly different. However, the Vp for the right and left ventricles in group 4 was significantly lower than in group 3 (19.02 vs. 9.78, p < 0.001; and 20.24 vs. 13.40, p < 0.001, respectively). The inter-observer variability had fair agreement with the intra-class correlation coefficient of 0.531 (95 % CI 0.393 - 0.646, p < 0.001).Conclusion:Hydrops fetalis secondary to fetal anemia is initially caused by hypervolemia rather than ventricular diastolic dysfunction while ventricular diastolic compromise is a late occurring consequence of persistent hypervolemia, different from the mechanism of hydropic changes caused by cardiac causes.
authors.forename: T
authors.initials: T
authors.lastname: Tongsong
authors.forename: F
authors.initials: F
authors.lastname: Tongprasert
authors.forename: K
authors.initials: K
authors.lastname: Srisupundit
authors.forename: S
authors.initials: S
authors.lastname: Luewan
authors.forename: K
authors.initials: K
authors.lastname: Traisrisilp
mesh_terms: D000328:Adult; D000751:Anemia, Neonatal / Q000000981:diagnostic imaging* / Q000503:physiopathology; D003937:Diagnosis, Differential; D003971:Diastole / Q000502:physiology*; D018618:Echocardiography, Doppler, Color / Q000379:methods*; D019561:Echocardiography, Four-Dimensional / Q000379:methods*; D005260:Female; D005318:Fetal Heart / Q000000981:diagnostic imaging*; D006333:Heart Failure / Q000151:congenital / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006352:Heart Ventricles / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006455:Hemoglobins, Abnormal / Q000502:physiology*; D006801:Humans; D015160:Hydrops Fetalis / Q000000981:diagnostic imaging / Q000503:physiopathology; D007090:Image Interpretation, Computer-Assisted; D008297:Male; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D011263:Pregnancy Trimester, Third; D018566:Pregnancy, High-Risk; D011446:Prospective Studies; D012016:Reference Values; D016216:Ultrasonography, Prenatal / Q000379:methods*; D014584:User-Computer Interface
chemical_list: D006455:Hemoglobins, Abnormal; C030448:hemoglobin Bart's