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Published on: June 29, 2013
Normative change with gestation in fetal intraventricular pressure difference with color M-mode Doppler
Yuka Yamamoto1, Ken Takahashi2, Ai Takamizu3
1Department of Obstetrics and Gynecology, Juntendo University Faculty of Medicine, Tokyo, Japan.
Insights
Intraventricular pressure difference (IVPD) increases with gestational age in fetuses, providing normative data for evaluating fetal heart function. This study establishes linear relationships for total and segmental IVPD throughout gestation.
Area of Science:
- Cardiology
- Fetal Physiology
- Medical Imaging
Background:
- Intraventricular pressure difference (IVPD) is crucial for assessing diastolic function, acting as a suction force.
- Understanding IVPD changes during gestation is vital for establishing normative fetal cardiac development data.
Purpose of the Study:
- To investigate changes in total and segmental IVPD in normal fetuses across gestation.
- To derive normative data equations for IVPD throughout fetal development.
Main Methods:
- Prospective enrollment of 137 healthy pregnant women (12-40 weeks gestation).
- Utilized color M-mode imaging and custom code to calculate IVPD.
- Segmental IVPD analysis included basal and mid-apical regions; Pearson's correlation assessed relationships.
Main Results:
- Significant positive linear relationships found between total IVPD and gestational age in both right (RV) and left ventricles (LV).
- Segmental IVPD (basal and mid-apical) also increased significantly with gestational age in both RV and LV.
- IVPD normalized by ventricular length (IVPG) showed a weak positive correlation with gestation.
Conclusions:
- Total and segmental IVPD demonstrate significant linear increases throughout fetal development.
- These findings provide essential normative data for fetal diastolic function assessment.
Aim:
The intraventricular pressure difference (IVPD) is the pressure difference in early diastole from the base to the apex of the ventricle. It is a useful marker for evaluating diastolic function because of its role as a suction force. This study investigated the changes in total and segmental IVPDs in normal fetuses throughout gestation to obtain normative data equations.
Methods:
One hundred thirty-seven healthy pregnant women at 12-40 weeks of gestation were prospectively enrolled to evaluate IVPD. The color M mode was performed, and the image was evaluated using our own code to calculate the IVPD. Segmental IVPD was divided into mid to apex and base. Pearson's correlation coefficient was used to evaluate this relationship.
Results:
There was a significant, positive relationship between IVPD and gestational age in both ventricles (right ventricle [RV]: r = 0.800, left ventricle [LV]: r = 0.818). As for segmental IVPD, basal and mid-apical IVPD also increased with gestation in both ventricles (RV: basal, r = 0.627; mid-apical, r = 0.705; LV: basal r = 0.758; mid-apical, r = 0.756). IVPG, which was calculated as IVPD/ventricular length, also showed a weak, positive relationship with gestation in both ventricles (RV r = 0.351, p < 0.001; LV r = 0.373, p < 0.001).
Conclusion:
The total and segmental IVPDs significantly increased linearly through time.
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