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Fetal myocardial peak systolic strain before and after intrauterine red blood cell transfusion – a tissue Doppler imaging study

  • Miriam Michel EMAIL logo , Ralf Schmitz , Ludwig Kiesel and Johannes Steinhard
Published/Copyright: May 13, 2012

Abstract

Objectives: The purpose of this study is to evaluate the cardiac function in anemic fetuses by tissue Doppler imaging (TDI) measuring the myocardial peak systolic strain (PS) in fetuses before and after intrauterine transfusion (IUT) of red blood cells.

Methods: In our prospective clinical study in anemic fetuses, high-frame-rate TDI data files from a four-chamber view of fetal hearts pre- and post-IUT were analyzed. The biventricular PS parameters of the mid-segment of the ventricular walls [region of interest (ROI) 1 right ventricle, ROI 2 left ventricle] and the basal segment of the ventricular walls (ROI 3 tricuspid annulus, ROI 4 mitral annulus) were compared with the PS data of the normal controls.

Results: We analyzed the pre-/post-data sets from the 15 hearts of anemic fetuses and from the 17 controls. The threshold of statistical significance was set to P≤0.05. Compared with the controls, in anemic fetuses the left ventricular longitudinal myocardial PS (ROI 2, P=0.001) and PS in the basal segment of the right ventricle (ROI 3 P=0.009) was significantly increased (absolute amount). Compared with pre-IUT, post-IUT PS decreased significantly in both ventricles (ROI 1 P=0.025, ROI 2 P=0.02). Compared with the controls, post-IUT left ventricular PS was still higher (absolute amount) (ROI 2, P=0.026; ROI 4, P=0.009).

Conclusions: The increase in myocardial PS due to severe fetal anemia is partially normalized by IUT. In anemic fetuses, assessment of TDI fetal myocardial PS is feasible.


Corresponding author: Miriam Michel Fetal Cardiac Imaging Research Group Department of Obstetrics and Gynecology Westfalian Wilhelms University Münster Albert-Schweitzer-Straße 33 48149 Münster Germany Tel.: +49-(0)251-8348228 Fax: +49-(0)251-8348210

Received: 2011-10-30
Revised: 2012-3-20
Accepted: 2012-4-10
Published Online: 2012-05-13
Published in Print: 2012-09-01

©2012 by Walter de Gruyter Berlin Boston

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