Prenatal prediction of Shone’s complex. The role of the degree of ventricular disproportion and speckle-tracking analysis
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Patrizio Moras
,
Giuseppe Rizzo
,
Cosimo Marco Campanale
Abstract
Objectives
Shone’s complex (SC) is characterized by sequential obstructions of left ventricular (LV) inflow and outflow. It can be associated with poor long-term prognosis when compared to Simple-Aortic Coarctation (S-CoA). We aimed to assess whether the degree of ventricular disproportion and 2D-speckle-tracking echocardiography (2D-STE) could improve the accuracy of prenatal prediction of SC.
Methods
75 consecutive fetuses were retrospectively enrolled from January 2010 to June 2021. Fetuses were divided into 4 groups (Group 1: SC; Group 2: S-CoA; Group 3: False Positive-Coarctation of the Aorta [FP-CoA]; group 4: controls). Comparisons for echocardiographic measures and myocardial deformation indices were performed. A receiver operating characteristic (ROC) analysis was performed on the MV/TV (mitral valve/tricuspid valve ratio) and LV GLS (global longitudinal strain) values to identify cut-offs to separate group 1 and 2 fetuses.
Results
SC fetuses showed a significant reduction in MV/TV when compared to S-CoA and FP-CoA fetuses (p<0.001). LV GLS in SC fetuses was significantly reduced compared to S-CoA fetuses (−13.3 ± 2.1% vs. −17.0 ± 2.2%, p=0.001). A cut-off value of 0.59 for MV/TV and −15.35% for LV GLS yielded a sensitivity of 76 and 82% and a specificity of 71 and 83% respectively in separating SC vs. S-CoA fetuses.
Conclusions
SC fetuses showed a more severe degree of ventricular disproportion and a lower LV GLS compared to S-CoA, FP-CoA and control fetuses. MV/TV and GLS are both predictors of SC. These findings may improve the quality of prenatal parental counselling.
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Research funding: None declared.
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Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
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Competing interests: Authors state no conflict of interest.
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Informed consent: Informed consent was obtained from all individuals included in this study.
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Ethical approval: The study was approved by the Institutional Review Board of Bambino Gesù Children’s Hospital, Rome.
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© 2022 Walter de Gruyter GmbH, Berlin/Boston
Articles in the same Issue
- Frontmatter
- Reviews
- Placenta Accreta Spectrum Part I: anesthesia considerations based on an extended review of the literature
- Placenta Accreta Spectrum Part II: hemostatic considerations based on an extended review of the literature
- Corner of Academy
- The impact of lateral placenta on preeclampsia and small for gestational age neonates: a systematic review and meta-analysis
- Original Articles – Obstetrics
- Fetal intelligent navigation echocardiography (FINE) has superior performance compared to manual navigation of the fetal heart by non-expert sonologists
- Evaluation of fetal middle adrenal artery Doppler and fetal adrenal gland size in pregnancies with fetal growth restriction: a case-control study
- First trimester low maternal serum pregnancy associated plasma protein-A (PAPP-A) as a screening method for adverse pregnancy outcomes
- Time interval to delivery in asymptomatic twin pregnancies with a short cervix at 23–28 weeks’ gestation
- Hepatic arterial buffer response in monochorionic diamniotic pregnancies with twin-to-twin transfusion syndrome
- Healthcare of pregnant women with diabetes during the COVID-19 pandemic: a Southern Brazilian cross-sectional panel data
- Attitudes toward COVID-19 vaccination of pregnant and lactating women in Hungary
- Maternal vitamin D levels correlate with fetal weight and bone metabolism during pregnancy: a materno-neonatal analysis of bone metabolism parameters
- Removal of pregnancy categories and likelihood of prescribing: a randomized trial
- Prenatal prediction of Shone’s complex. The role of the degree of ventricular disproportion and speckle-tracking analysis
- Original Article – Fetus
- The effect of middle cerebral artery peak systolic velocity on prognosis in early and late-onset fetal growth restriction
- Original Articles – Neonates
- Assessment of salivary cortisol concentrations for procedural pain monitoring in newborns
- Impact on neonatal morbidities after a change in policy to administer antenatal corticosteroids to mothers at risk for late preterm delivery
- The Apgar score in clinical research: for what, how and by whom it is used
- Short Communication
- Visitor restriction during the COVID-19 pandemic did not impact rates of Staphylococcus aureus colonization in the NICU patients
- Letter to the Editor
- Knowledge and attitudes of pregnant women on maternal immunization against COVID-19: correspondence
Articles in the same Issue
- Frontmatter
- Reviews
- Placenta Accreta Spectrum Part I: anesthesia considerations based on an extended review of the literature
- Placenta Accreta Spectrum Part II: hemostatic considerations based on an extended review of the literature
- Corner of Academy
- The impact of lateral placenta on preeclampsia and small for gestational age neonates: a systematic review and meta-analysis
- Original Articles – Obstetrics
- Fetal intelligent navigation echocardiography (FINE) has superior performance compared to manual navigation of the fetal heart by non-expert sonologists
- Evaluation of fetal middle adrenal artery Doppler and fetal adrenal gland size in pregnancies with fetal growth restriction: a case-control study
- First trimester low maternal serum pregnancy associated plasma protein-A (PAPP-A) as a screening method for adverse pregnancy outcomes
- Time interval to delivery in asymptomatic twin pregnancies with a short cervix at 23–28 weeks’ gestation
- Hepatic arterial buffer response in monochorionic diamniotic pregnancies with twin-to-twin transfusion syndrome
- Healthcare of pregnant women with diabetes during the COVID-19 pandemic: a Southern Brazilian cross-sectional panel data
- Attitudes toward COVID-19 vaccination of pregnant and lactating women in Hungary
- Maternal vitamin D levels correlate with fetal weight and bone metabolism during pregnancy: a materno-neonatal analysis of bone metabolism parameters
- Removal of pregnancy categories and likelihood of prescribing: a randomized trial
- Prenatal prediction of Shone’s complex. The role of the degree of ventricular disproportion and speckle-tracking analysis
- Original Article – Fetus
- The effect of middle cerebral artery peak systolic velocity on prognosis in early and late-onset fetal growth restriction
- Original Articles – Neonates
- Assessment of salivary cortisol concentrations for procedural pain monitoring in newborns
- Impact on neonatal morbidities after a change in policy to administer antenatal corticosteroids to mothers at risk for late preterm delivery
- The Apgar score in clinical research: for what, how and by whom it is used
- Short Communication
- Visitor restriction during the COVID-19 pandemic did not impact rates of Staphylococcus aureus colonization in the NICU patients
- Letter to the Editor
- Knowledge and attitudes of pregnant women on maternal immunization against COVID-19: correspondence
