Time-interval changes of cardiac cycles in fetal growth restriction.
OBJECTIVE
The aims of this study were to investigate the time intervals of each component of cardiac flow velocity waveforms (FVWs) in fetuses with fetal growth restriction (FGR) and to compare these with those of normal fetuses using reference ranges.


METHODS
The durations of atrioventricular (AV) valve opening (AVVO), AV valve closure (AVVC), total E- (total-E) and A- (total-A) waves, total ejection time (total-ET), acceleration time (acc-E for E-wave, acc-A for A-wave, and acc-ET for ejection time), and deceleration time (dec-E for E-wave, dec-A for A-wave, and dec-ET for ejection time) were measured in fetuses with FGR. All variables were analyzed using z-scores.


RESULTS
Measurements of 17 growth-restricted fetuses were obtained. The time intervals between the last Doppler examination and delivery ranged from 0 to 6 days, with a median of 1 day. Significant increases were observed in AVVO, total-E, dec-E, and acc-A of the left heart. acc-E, acc-ET and AVVC of the left heart were significantly decreased. In the right heart, AVVO, total-E and dec-E were significantly increased.


CONCLUSIONS
A prolonged time interval between early ventricular inflow and atrial contraction, as well as increased duration of AV valve opening, may reflect hemodynamic alterations in FGR fetuses.
Department of Obstetrics and Gynecology, Osaka City University Graduate School of Medicine, Osaka, Japan.
Yasushi
Y
Kurihara
Department of Obstetrics and Gynecology, Osaka City University Graduate School of Medicine, Osaka, Japan. Electronic address: dtachibana@med.osaka-cu.ac.jp.
Daisuke
D
Tachibana
Department of Obstetrics and Gynecology, Osaka City University Graduate School of Medicine, Osaka, Japan.
Natsuko
N
Yokoi
Department of Obstetrics and Gynecology, Izumiotsu City Hospital, Osaka, Japan.
Kayoko
K
Nakagawa
Department of Obstetrics and Gynecology, Izumiotsu City Hospital, Osaka, Japan.
Kohei
K
Kitada
Department of Obstetrics and Gynecology, Osaka City University Graduate School of Medicine, Osaka, Japan.
Masami
M
Hayashi
Department of Obstetrics and Gynecology, Osaka City University Graduate School of Medicine, Osaka, Japan.
Sakika
S
Yanai
Department of Obstetrics and Gynecology, Osaka City University Graduate School of Medicine, Osaka, Japan.
Hiroko
H
Katayama
Department of Obstetrics and Gynecology, Osaka City University Graduate School of Medicine, Osaka, Japan.
Akihiro
A
Hamuro
Department of Obstetrics and Gynecology, Osaka City University Graduate School of Medicine, Osaka, Japan.
Takuya
T
Misugi
Department of Obstetrics and Gynecology, Osaka City General Hospital, Osaka, Japan.
Kazuharu
K
Tanaka
Laboratory of Statistics, Osaka City University Graduate School of Medicine, Osaka, Japan.
Mitsuru
M
Fukui
Department of Obstetrics and Gynecology, Osaka City University Graduate School of Medicine, Osaka, Japan.
Masayasu
M
Koyama
D000328:Adult; D001145:Arrhythmias, Cardiac / Q000000981:diagnostic imaging* / Q000196:embryology / Q000209:etiology; D001724:Birth Weight; D002681:China; D003326:Coronary Circulation; D015150:Echocardiography, Doppler; D005260:Female; D005317:Fetal Growth Retardation / Q000503:physiopathology*; D005865:Gestational Age; D006329:Heart Conduction System / Q000000981:diagnostic imaging* / Q000196:embryology / Q000503:physiopathology; D006773:Hospitals, Municipal; D006785:Hospitals, University; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D011247:Pregnancy; D013318:Stroke Volume; D013997:Time Factors; D016216:Ultrasonography, Prenatal; D055815:Young Adult
Cardiac cycles; Fetal circulation; Fetal growth restriction; Time-interval