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Updated: Jun 12, 2026
Murine Fetal Echocardiography
Published on: February 15, 2013
Understanding changes in echocardiographic parameters at different ages following fetal growth restriction: a
Mette van de Meent1, Kirsten T Nijholt1, Shary C A Joemmanbaks1
1Division Women and Baby, Department of Obstetrics, Wilhelmina Children's Hospital, Utrecht University, Utrecht, The Netherlands.
Insights
Fetal growth restriction (FGR) leads to neonatal cardiac changes detected by echocardiography. These early signs of cardiovascular risk in FGR offspring require further research for long-term prediction.
Area of Science:
- Cardiology and Developmental Biology
- Perinatal Medicine and Cardiovascular Health
Background:
- Fetal growth restriction (FGR) is a significant risk factor for developing cardiovascular disease later in life due to cardiac remodeling and programming.
- Echocardiography is a noninvasive imaging technique that can assess cardiac structure and function, potentially identifying early signs of cardiovascular risk in FGR offspring.
Approach:
- A systematic review and meta-analysis was conducted, searching PubMed and Embase.com for studies reporting echocardiographic parameters in placental insufficiency-induced FGR offspring across different species and ages.
- Data from six animal studies and 49 human studies were included. Meta-analyses were performed on human studies, with limitations noted for animal studies and adult human data due to insufficient study numbers.
Key Points:
- Neonatal human FGR offspring exhibited reduced left ventricular mass, interventricular septum thickness, mitral annular peak velocity, and mitral lateral early diastolic velocity compared to controls.
- No significant echocardiographic differences were observed during childhood, though analyses were limited by small age ranges and study numbers. Limited data exists for adult FGR offspring.
- Few studies on myocardial strain analysis indicated subtle preclinical changes in global longitudinal strain in FGR offspring. Study quality was generally low, with high risk of bias in animal studies.
Conclusions:
- Echocardiography can detect early, preclinical cardiovascular changes in neonatal FGR offspring, highlighting its potential as a tool for risk identification.
- Clinical application faces challenges in determining optimal timing and correlating echocardiographic findings with long-term cardiovascular outcomes, suggesting limitations of echocardiography alone.
- Future research should prioritize myocardial strain analysis and integrate echocardiography with other imaging and non-imaging techniques for improved cardiovascular risk estimation in FGR.
Abstract:
Fetal growth restriction (FGR) increases cardiovascular risk by cardiac remodeling and programming. This systematic review and meta-analysis across species examines the use of echocardiography in FGR offspring at different ages. PubMed and Embase.com were searched for animal and human studies reporting on echocardiographic parameters in placental insufficiency-induced FGR offspring. We included six animal and 49 human studies. Although unable to perform a meta-analysis of animal studies because of insufficient number of studies per individual outcome, all studies showed left ventricular dysfunction. Our meta-analyses of human studies revealed a reduced left ventricular mass, interventricular septum thickness, mitral annular peak velocity, and mitral lateral early diastolic velocity at neonatal age. No echocardiographic differences during childhood were observed, although the small age range and number of studies limited these analyses. Only two studies at adult age were performed. Meta-regression on other influential factors was not possible due to underreporting. The few studies on myocardial strain analysis showed small changes in global longitudinal strain in FGR offspring. The quality of the human studies was considered low and the risk of bias in animal studies was mostly unclear. Echocardiography may offer a noninvasive tool to detect early signs of cardiovascular predisposition following FGR. Clinical implementation yet faces multiple challenges including identification of the most optimal timing and the exact relation to long-term cardiovascular function in which echocardiography alone might be limited to reflect a child's vascular status. Future research should focus on myocardial strain analysis and the combination of other (non)imaging techniques for an improved risk estimation.NEW & NOTEWORTHY Our meta-analysis revealed echocardiographic differences between fetal growth-restricted and control offspring in humans during the neonatal period: a reduced left ventricular mass and interventricular septum thickness, reduced mitral annular peak velocity, and mitral lateral early diastolic velocity. We were unable to pool echocardiographic parameters in animal studies and human adults because of an insufficient number of studies per individual outcome. The few studies on myocardial strain analysis showed small preclinical changes in FGR offspring.
