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Fetal and Neonatal Diastolic Myocardial Strain Rate: Normal Reference Ranges and Reproducibility in a Prospective, Longitudinal Cohort of Pregnancies.
- Source :
-
Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography [J Am Soc Echocardiogr] 2016 Jul; Vol. 29 (7), pp. 663-9. Date of Electronic Publication: 2016 Apr 01. - Publication Year :
- 2016
-
Abstract
- Background: Normative fetal diastolic strain rate values have not been comprehensively reported. The aims of this study were to report normative data for diastolic strain rate parameters across gestation and upon delivery, determine the effect of advancing gestational age on these measures, and compare interobserver variability at multiple gestational age time points.<br />Methods: Sixty gravid women were enrolled before 20 weeks' gestation. The following measures were obtained by two blinded observers at five time points across gestation and at 4 to 8 weeks' postnatal age: global left ventricular circumferential strain rate peak E and A waves, global left and right ventricular longitudinal strain rate peak E and A waves, and mitral and tricuspid valve E/A ratios. Reproducibility was assessed using intraclass correlation and Bland-Altman analysis. Least square means analysis was used to evaluate for changes across gestational age.<br />Results: Left ventricular longitudinal and circumferential diastolic strain rate values decreased across gestation, while right ventricular longitudinal values remained stable. With delivery, left ventricular values remained fairly stable, while right ventricular values increased. Intraclass correlations for diastolic strain rate values were 0.68 to 0.94 at ≥24 weeks' gestation and 0.25 to 0.82 for values at 20 to 21 weeks' gestation. Intraclass correlations ranged from 0.49 to 0.90 for mitral valve and tricuspid valve E/A ratios across gestation.<br />Conclusions: Fetal measures of diastolic strain rate have acceptable reproducibility after 24 weeks' gestation. The described changes across gestation likely reflect intrinsic myocardial adaptation to loading conditions. These reference ranges can be used to assess effects of various disease states on fetal myocardial deformation.<br /> (Copyright © 2016 American Society of Echocardiography. Published by Elsevier Inc. All rights reserved.)
- Subjects :
- Aging physiology
Cohort Studies
Echocardiography methods
Elastic Modulus physiology
Female
Gestational Age
Humans
Infant, Newborn
Longitudinal Studies
Male
Reproducibility of Results
Sensitivity and Specificity
Stress, Mechanical
Stroke Volume physiology
Tensile Strength physiology
Texas
Ultrasonography, Prenatal methods
Echocardiography standards
Heart Ventricles diagnostic imaging
Heart Ventricles embryology
Pregnancy physiology
Ultrasonography, Prenatal standards
Ventricular Function, Left physiology
Subjects
Details
- Language :
- English
- ISSN :
- 1097-6795
- Volume :
- 29
- Issue :
- 7
- Database :
- MEDLINE
- Journal :
- Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography
- Publication Type :
- Academic Journal
- Accession number :
- 27049665
- Full Text :
- https://doi.org/10.1016/j.echo.2016.02.017