title: How often an isolated cardiac disproportion predicts a coarctation of the aorta? Single center experience and systematic review of the literature.
abstract: BACKGROUND
  Cardiac disproportion is considered as an indirect sign of coarctation of the aorta (CoA). In this review, we have reassessed the positive predictive value (PPV) of such finding for a postnatal confirmation of CoA.
  
  
  METHODS
  All cases of isolated cardiac disproportion diagnosed in the four-chamber and/or three-vessel/three-vessel and trachea views (right/left sections >1.5) were included. Postnatal cardiac findings were recorded. Additionally, a systematic literature search (PubMed, EMBASE, Cochrane library, and the reference lists of identified articles) regarding the association between antenatally detected cardiac disproportion and postnatal confirmation of CoA was performed. Data from our center were pooled with those derived from the literature.
  
  
  RESULTS
  Ten fetuses with isolated cardiac disproportion were selected from our center and 259 from the literature review. CoA was postnatally confirmed in 101/269 (PPV 38%). PPV of antenatal cardiac findings was significantly higher in earlier gestation (23/27, 85% <26+0weeks versus 11/39, 28%≥26+0weeks, p < .001). No significant difference was noticed comparing ventricular disproportion with combined ventricular and great vessels disproportion (86/230 versus 15/39, p  .89).
  
  
  CONCLUSIONS
  Isolated cardiac disproportion has an overall chance of one in three of heralding a CoA in the neonate. The specificity of these findings is significantly higher in the second trimester.
authors.affiliation: a Department of Surgical Sciences, Obstetrics and Gynaecology Unit , University of Parma , Parma , Italy.
authors.forename: Tullio
authors.initials: T
authors.lastname: Ghi
authors.affiliation: a Department of Surgical Sciences, Obstetrics and Gynaecology Unit , University of Parma , Parma , Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Dall'Asta
authors.affiliation: b Paediatric Hospital "P. Barilla", Neonatology Unit , University of Parma , Parma , Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Cavalli
authors.affiliation: a Department of Surgical Sciences, Obstetrics and Gynaecology Unit , University of Parma , Parma , Italy.
authors.forename: Letizia
authors.initials: L
authors.lastname: Galli
authors.affiliation: b Paediatric Hospital "P. Barilla", Neonatology Unit , University of Parma , Parma , Italy.
authors.forename: Adi
authors.initials: A
authors.lastname: Weiss
authors.affiliation: c Department of Neuroscience , University of Parma , Parma , Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Pedrazzi
authors.affiliation: a Department of Surgical Sciences, Obstetrics and Gynaecology Unit , University of Parma , Parma , Italy.
authors.forename: Christine Tita
authors.initials: CT
authors.lastname: Kaihura
authors.affiliation: a Department of Surgical Sciences, Obstetrics and Gynaecology Unit , University of Parma , Parma , Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Volpe
authors.affiliation: b Paediatric Hospital "P. Barilla", Neonatology Unit , University of Parma , Parma , Italy.
authors.forename: Aldo
authors.initials: A
authors.lastname: Agnetti
authors.affiliation: a Department of Surgical Sciences, Obstetrics and Gynaecology Unit , University of Parma , Parma , Italy.
authors.forename: Tiziana
authors.initials: T
authors.lastname: Frusca
mesh_terms: D001017:Aortic Coarctation / Q000000981:diagnostic imaging* / Q000196:embryology; D004452:Echocardiography; D005260:Female; D005318:Fetal Heart / Q000000981:diagnostic imaging*; D005865:Gestational Age; D006352:Heart Ventricles / Q000000981:diagnostic imaging* / Q000196:embryology; D006801:Humans; D007231:Infant, Newborn; D011237:Predictive Value of Tests; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D016216:Ultrasonography, Prenatal; D016276:Ventricular Function
keywords: Cardiac disproportion; antenatal screening; coarctation of the aorta; fetal echocardiography; pediatric cardiology