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Early cardiac remodeling in aortic coarctation: insights from fetal and neonatal functional and structural assessment
- Source :
- ULTRASOUND IN OBSTETRICS & GYNECOLOGY, r-FSJD: Repositorio Institucional de Producción Científica de la Fundació Sant Joan de Déu, Fundació Sant Joan de Déu, Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology, r-FSJD. Repositorio Institucional de Producción Científica de la Fundació Sant Joan de Déu, instname
- Publication Year :
- 2020
- Publisher :
- WILEY-BLACKWELL, 2020.
-
Abstract
- OBJECTIVES: Coarctation of the aorta (CoA) is associated with left ventricular (LV) dysfunction in neonates and adults. Cardiac structure and function in fetal CoA and cardiac adaptation to early neonatal life have not been described. We aimed to investigate the presence of cardiovascular structural remodeling and dysfunction in fetuses with CoA and their early postnatal cardiac adaptation. METHODS: This was a prospective observational case-control study, conducted between 2011 and 2018 in a single tertiary referral center, of fetuses with CoA and gestational age-matched normal controls. All fetuses/neonates underwent comprehensive echocardiographic evaluation in the third trimester of pregnancy and after birth. Additionally, myocardial microstructure was assessed in one fetal and one neonatal CoA-affected heart specimen, using synchrotron radiation-based X-ray phase-contrast microcomputed tomography and histology, respectively. RESULTS: We included 30 fetuses with CoA and 60 gestational age-matched controls. Of these, 20 CoA neonates and 44 controls were also evaluated postnatally. Fetuses with CoA showed significant left-to-right volume redistribution, with right ventricular (RV) size and output dominance and significant geometry alterations with an abnormally elongated LV, compared with controls (LV midventricular sphericity index (median (interquartile range; IQR), 2.4 (2.0-2.7) vs 1.8 (1.7-2.0); P
- Subjects :
- Technology
Contraction (grammar)
synchrotron tomography
0302 clinical medicine
Pregnancy
Ventricular hypertrophy
Interquartile range
echocardiography
VASCULAR DYSFUNCTION
Prospective Studies
030212 general & internal medicine
GESTATIONAL-AGE
ULTRASOUND
neonatal cardiac function
030219 obstetrics & reproductive medicine
Ventricular Remodeling
Radiological and Ultrasound Technology
Radiology, Nuclear Medicine & Medical Imaging
Obstetrics & Gynecology
Obstetrics and Gynecology
General Medicine
MYOCARDIAL DEFORMATION
fetal cardiac function
CONGENITAL HEART-DISEASE
Echocardiography
Cardiology
Gestation
Female
Life Sciences & Biomedicine
Adult
DIMENSIONS
medicine.medical_specialty
Heart Ventricles
Coarctation of the aorta
Diastole
Gestational Age
Aortic Coarctation
Ultrasonography, Prenatal
03 medical and health sciences
Fetal Heart
aortic coarctation
FETUSES
Internal medicine
medicine
Humans
Radiology, Nuclear Medicine and imaging
REPAIR
Fetus
Science & Technology
business.industry
Infant, Newborn
X-Ray Microtomography
Acoustics
PERFORMANCE
medicine.disease
Reproductive Medicine
Case-Control Studies
business
Subjects
Details
- ISSN :
- 09607692 and 14690705
- Database :
- OpenAIRE
- Journal :
- ULTRASOUND IN OBSTETRICS & GYNECOLOGY, r-FSJD: Repositorio Institucional de Producción Científica de la Fundació Sant Joan de Déu, Fundació Sant Joan de Déu, Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology, r-FSJD. Repositorio Institucional de Producción Científica de la Fundació Sant Joan de Déu, instname
- Accession number :
- edsair.doi.dedup.....c0bbeba21f718c68937a4d9c619eb021