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Am J Perinatol 2017; 34(13): 1354-1361
DOI: 10.1055/s-0037-1603652
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Fetal Heart Function by Tricuspid Annular Plane Systolic Excursion and Ventricular Shortening Fraction Using STIC M-Mode: Reference Ranges and Validation

Giselle Darahem Tedesco
1   Department of Obstetrics, Paulista School of Medicine, Federal University of São Paulo (EPM-UNIFESP), São Paulo, SP, Brazil
,
Marilim de Souza Bezerra
1   Department of Obstetrics, Paulista School of Medicine, Federal University of São Paulo (EPM-UNIFESP), São Paulo, SP, Brazil
,
Fernanda Silveira Bello Barros
1   Department of Obstetrics, Paulista School of Medicine, Federal University of São Paulo (EPM-UNIFESP), São Paulo, SP, Brazil
,
Wellington P. Martins
2   Department of Gynecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo (FMRP-USP), Ribeirão Preto, São Paulo, SP, Brazil
,
Luciano Marcondes Machado Nardozza
1   Department of Obstetrics, Paulista School of Medicine, Federal University of São Paulo (EPM-UNIFESP), São Paulo, SP, Brazil
,
Rosiane Mattar
1   Department of Obstetrics, Paulista School of Medicine, Federal University of São Paulo (EPM-UNIFESP), São Paulo, SP, Brazil
,
Antonio Fernandes Moron
1   Department of Obstetrics, Paulista School of Medicine, Federal University of São Paulo (EPM-UNIFESP), São Paulo, SP, Brazil
,
Liliam Cristine Rolo
1   Department of Obstetrics, Paulista School of Medicine, Federal University of São Paulo (EPM-UNIFESP), São Paulo, SP, Brazil
,
Edward Araujo Júnior
1   Department of Obstetrics, Paulista School of Medicine, Federal University of São Paulo (EPM-UNIFESP), São Paulo, SP, Brazil
› Author Affiliations
Further Information

Publication History

24 March 2017

28 April 2017

Publication Date:
01 June 2017 (online)

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Abstract

Objective To determine the reference values for fetal tricuspid annular plane systolic excursion (f-TAPSE) and fetal ventricular shortening fraction (f-VSF) using spatiotemporal image correlation (STIC) with M-mode, and validate these curves in fetuses of pregnant women with preexisting diabetes mellitus (DM) and with intrauterine growth restriction (IUGR).

Study Design Crosssectional study assessed 300 fetal cardiac volumes of normal pregnancies between 20 and 33 + 6 weeks of gestation. For the construction of the reference curves, we used a polynomial regression model adjusted with the coefficient of determination (R2). For the calculation of reproducibility, the concordance correlation coefficient (CCC) was used.

Results f-TAPSE value correlated with gestational age (GA, R2 = 0.46), whereas fetal right ventricular shortening fraction (f-RVSF, R2 = 0.02) and fetal left ventricular shortening fraction (f-LVSF, R2 = 0.005) did not vary with GA. Fetuses of pregnant women with preexisting DM (30) had lower values of f-RVSF (p = 0.028), f-LVSF (p = 0.001), and f-TAPSE (p = 0.009) than normal fetuses. The f-TAPSE values were lower (p = 0.005) in IUGR group (17). The f-TASPSE values showed adequate reliability as well as good intra and interobserver concordance (CCC = 0.95 and 0.79, respectively).

Conclusion The reference ranges for f-TAPSE, f-RVSF, and f-LVSF using the STIC M-mode were established and had good reproducibility for f-TAPSE measurements.

Keywords

reference ranges - fetal heart function - tricuspid annular plane systolic excursion - ventricular shortening fraction - M-mode - three-dimensional ultrasound
 

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