Poor Correlation between Fetal Tissue Doppler Imaging and Pulsed Wave Myocardial Performance Indices

Area of Science:

• Cardiology
• Fetal Medicine
• Diagnostic Imaging

Background:

• Myocardial Performance Indices (MPIs) using Tissue Doppler Imaging (TDI) and Pulsed Wave Doppler (PWD) are explored for fetal cardiology.
• Assessing the correlation between TDI-MPI and PWD-MPI is crucial for their clinical application.

Purpose of the Study:

• To determine the correlation between TDI-MPI and PWD-MPI in fetuses.
• To evaluate the interchangeability of these two Doppler-based methods for fetal cardiac function assessment.

Main Methods:

• A cohort of uncomplicated singleton fetuses (22-39 weeks gestation) was studied.
• A single sonologist acquired Doppler waveforms for both TDI-MPI and PWD-MPI.
• PWD-MPI was calculated algorithmically, while TDI-MPI intervals were manually measured.

Main Results:

• Both TDI-MPI and PWD-MPI demonstrated high achievability and repeatability.
• TDI-MPI yielded significantly lower right-sided and higher left-sided MPI values compared to PWD-MPI.
• Differences may reflect TDI evaluating myocardial contraction and PWD evaluating blood flow.

Conclusions:

• A weak correlation exists between PWD-MPI and TDI-MPI, indicating they are not interchangeable.
• High variability in TDI waveforms and lack of standardized analysis hinder its adoption.
• Further research is required before TDI-MPI can be routinely used in fetal cardiology.