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Updated: Jul 4, 2026
Fetal Echocardiography and Pulsed-wave Doppler Ultrasound in a Rabbit Model of Intrauterine Growth Restriction
Published on: June 29, 2013
Electrophysiological characterization of pre-adolescents born with intrauterine growth restriction: insights from
Freddy L Bueno-Palomeque1,2,3, Ernesto Zacur4, Esther Pueyo1,2
1BSICoS Group, I3A, IIS Aragón, Universidad de Zaragoza, C/Mariano Esquillor s/n, Zaragoza, Spain.
Insights
Intrauterine growth restriction (IUGR) in pre-adolescents is linked to cardiac electrical changes, including prolonged QRS duration. Computer simulations confirm that IUGR-induced anatomical heart remodeling primarily affects depolarization, not repolarization.
Area of Science:
- Cardiology
- Biomedical Engineering
- Developmental Biology
Background:
- Intrauterine growth restriction (IUGR) is associated with long-term cardiovascular risks.
- Cardiac anatomical remodeling in IUGR can influence heart electrical activity.
- Electrocardiogram (ECG) biomarkers can reflect these electrical changes.
Purpose of the Study:
- To analyze ECG biomarkers in pre-adolescents with severe IUGR.
- To investigate the relationship between IUGR-induced cardiac anatomical changes and ECG findings using computer simulations.
- To understand the impact of IUGR on cardiac depolarization and repolarization.
Main Methods:
- Analysis of ECG recordings in severe IUGR pre-adolescents and controls.
- Application of Principal Component Analysis (PCA) for enhanced QRS and T-wave analysis.
- Development of in silico electrophysiological models based on clinical IUGR anatomical data.
Main Results:
- IUGR subjects showed a 4ms increase in QRS duration and a 2ms increase in T peak-to-end interval compared to controls.
- In silico models with IUGR-like anatomical changes (e.g., increased wall thickness) replicated increased QRS duration and T peak-to-end interval.
- QT interval changes were observed but not linearly correlated with wall thickness modifications.
Conclusions:
- Cardiac remodeling in IUGR significantly impacts depolarization, as evidenced by prolonged QRS duration.
- Repolarization intervals show alterations but are not directly proportional to the degree of geometric remodeling.
- Findings underscore the importance of geometric and volumetric changes in IUGR-related cardiac remodeling and highlight the need for further electrophysiological research.
Abstract:
Anatomical changes associated with intra-uterine growth restriction (IUGR) have been observed in different age groups and linked to cardiovascular complications. This study analysed the electrocardiogram (ECG) in pre-adolescents with severe IUGR, comparing QRS complex and T-wave biomarkers with controls. Computer simulations explored links between anatomical re-modelling and ECG biomarkers, providing insights into the potential cardiovascular risk associated with IUGR-induced re-modelling. Clinical recordings were analysed using principal component analysis (PCA) to compute spatially transformed leads, enhancing QRS complex and T-wave delineation for depolarization and repolarization assessment. Transformed leads analysis revealed a 4-ms increase in QRS complex duration (QRS ) and a 2-ms increase in the T peak-to-end interval (T ) in IUGR subjects compared to controls. We conducted electrophysiological in silico simulations using anatomical models based on clinical IUGR data. These models, derived from a reference control, incorporated key geometric changes associated with IUGR, the apex-base length, basal diameter, wall thickness ( ) and ventricular tissue volume, to assess their impact on depolarization and repolarization intervals. In silico PCA leads showed increased QRS , QRS amplitude and T in globular models, consistent with clinical data. Despite the QRS increase, the QT interval increases but is not linearly related to the change. These findings suggest that cardiac re-modelling primarily influences the depolarization cycle, notably QRS , while repolarization intervals increase but are not directly related to the increase. The study highlights the impact of geometric and volumetric changes in IUGR-related cardiac re-modelling, also emphasizing the need for further research on electrophysiological re-modelling and its effects on cardiac function. KEY POINTS: Intrauterine growth restriction (IUGR) is associated with long-term cardiovascular complications, including changes in the heart's electrical activity. Cardiac re-modelling as a consequence of IUGR can lead to electrical changes that can be assessed through an electrocardiogram (ECG). This study analysed ECGs in pre-adolescents with severe IUGR, revealing prolonged depolarization duration (QRS complex duration) and repolarization (T peak-to-end interval) compared to healthy controls. Computational models incorporating clinically observed anatomical changes, such as increased ventricular wall thickness and altered heart geometry, were used to assess their impact on electrical function, and determine whether these structural modifications contribute to the ECG alterations observed in clinical data. Both clinical data analysis and simulation findings showed significant shifts in depolarization-based biomarkers and smaller, and non-linear changes to geometrical changes, in repolarization intervals, highlighting how cardiac re-modelling in IUGR affects heart function as measured by ECG.
