4 years ago

Assessment of diastolic function of normal fetal heart using the Dual gate Doppler method

Sumito Nagasaki, Mineto Morita, Rei Ueyama, Mayumi Takano, Masahiko Nakata
Objectives The ratio of mitral peak early diastolic filling to early diastolic mitral annular velocity (E/e') reflects diastolic cardiac function in adults. The Dual gate Doppler (DD) method enables measurements of E/e' in the same heartbeat. This study was designed to assess the utility of the DD method for measurement of fetal E/e', and to determine reference ranges for normal fetuses. Methods This prospective study comprised normal singleton pregnancies between 16 and 36 weeks of gestational age (GA). To calculate fetal E/e', the apical or basal 4-chamber view was demonstrated. Each E wave velocity on pulsed-wave Doppler imaging and each e' wave on tissue Doppler imaging were measured simultaneously according to the DD method. Results A total of 133 pregnancies were included in this study, and all E/e' measurements were successful. Significant correlations were found between GA and left ventricular (LV) E/e' (rs = –0.666, P < 0.001), and between GA and right ventricular (RV) E/e' (rs = –0.607, P < 0.001). The regression equations for bilateral E/e' were as follows: LV-E/e' = 17.341 – 0.631GA + 0.008xGA 2 (R2 = 0.440, SD 1.333); and RV-E/e' = 19.156 – 0.794GA + 0.012GA 2 (R2 = 0.419, SD 1.329). Conclusions Bilateral E/e' of normal fetuses, measured using the DD method, decreased with GA, which is considered related to myocardial maturity. The DD method is useful and convenient for evaluating fetal E/e’ to estimate diastolic function in the prenatal period. Clinical Trial Registration This study was retrospectively registered with Japanese Clinical Trial Registry "UMIN-CTR" on 23 March 2017 (http://www.umin.ac.jp/ctr/index-j.htm) and was given a trial ID number UMIN000026656.

Publisher URL: http://onlinelibrary.wiley.com/resolve/doi

DOI: 10.1002/uog.18821

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