Perinatal Changes in Fetal Ventricular Geometry, Myocardial Performance, and Cardiac Function in Normal Term...

Area of Science:

• Cardiology
• Fetal Medicine
• Neonatal Physiology

Background:

• The term fetal heart experiences increased hemodynamic workload from growth and altered fetoplacental circulation.
• Cardiovascular adaptations in human fetuses and neonates require further elucidation.

Purpose of the Study:

• To evaluate perinatal cardiovascular changes in ventricular geometry.
• To assess myocardial performance in normal term fetuses during the perinatal period.

Main Methods:

• Prospective study of 108 uncomplicated term pregnancies.
• Utilized M-mode, 2D, pulsed wave Doppler, tissue Doppler, and 2D speckle-tracking imaging.
• Acquired echocardiographic data prenatally and within 24 hours of birth.

Main Results:

• Significant perinatal shifts observed in right ventricular (RV) and left ventricular (LV) geometry (e.g., RV/LV end-diastolic dimension ratio changed from 1.2 to 0.8).
• Marked perinatal improvements in global myocardial performance (LV MPI 0.60 to 0.47; RV MPI 0.61 to 0.42).
• Changes noted in systolic function (LV/RV longitudinal strain rate) and diastolic function (LV E'/A').

Conclusions:

• The perinatal period induces substantial changes in fetal ventricular geometry and cardiac function.
• These adaptations are driven by significant alterations in loading conditions.
• Knowledge of these normal perinatal cardiac changes aids understanding of pathological pregnancies.