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Fetal Echocardiography and Pulsed-wave Doppler Ultrasound in a Rabbit Model of Intrauterine Growth Restriction
Published on: June 29, 2013
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Subclinical myocardial dysfunction among fetal growth restriction neonates: a case-control study
Vidya Nayak1, Ashwal A J2, Leslie Edward Lewis3
1Department of Cardiovascular Technology, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India.
Summary
Neonates with fetal growth restriction (FGR) show altered cardiac structure and function, including reduced ejection fraction and global longitudinal strain, indicating impaired adaptation to postnatal demands compared to appropriate-for-gestational-age infants.
Area of Science:
- Neonatal Cardiology
- Fetal Growth Restriction (FGR)
- Echocardiography
Background:
- Fetal growth restriction (FGR) is a significant concern in neonatal health, potentially impacting cardiac development and function.
- Early identification of cardiac changes in FGR neonates is crucial for timely intervention and improved outcomes.
- Conventional echocardiography, tissue Doppler imaging (TDI), and speckle tracking echocardiography offer advanced methods for cardiac assessment.
Purpose of the Study:
- To evaluate cardiac structural and functional changes in neonates with fetal growth restriction (FGR).
- To compare these changes against appropriate-for-gestational-age (AGA) neonates.
- To utilize advanced echocardiographic techniques including TDI and speckle tracking for detailed cardiac analysis.
Main Methods:
- A case-control study involving 85 FGR neonates and 75 non-FGR, AGA neonates.
- Assessment of biophysical profiles and echocardiographic parameters: cardiac dimensions, Left Ventricular Ejection Fraction (LV EF), Mitral valve Doppler flow velocities, myocardial performance index, tissue annular velocities, and LV global longitudinal strain (GLS).
- Categorization of FGR neonates into symmetric (37) and asymmetric (48) types.
Main Results:
- FGR neonates exhibited reduced mean Left Ventricular Ejection Fraction (LV EF) compared to AGA controls (66.14±3.85% vs 69.46±3.58%, p<0.001).
- Altered Left Ventricular E/E' was observed in both symmetric and asymmetric FGR neonates, indicating impaired diastolic function.
- A significant reduction in LV global longitudinal strain (GLS) was found in FGR neonates (-20.69±2.7% vs -19.06±2.9% in non-FGR and FGR, respectively, p<0.001).
Conclusions:
- Fetal growth restriction (FGR) neonates demonstrate significant alterations in cardiac geometry compared to appropriate-for-gestational-age (AGA) controls.
- FGR neonates show reduced LV EF, fractional shortening (FS), and LV global longitudinal strain (GLS).
- These findings suggest a failure of the neonatal heart to adapt to increased postnatal cardiac workload in the presence of FGR.
