Heart stroke volume, cardiac output, and ejection fraction in 265 normal fetus in the second half of gestation assessed by 4D ultrasound using spatio-temporal image correlation

Heart stroke volume, cardiac output, and ejection fraction in 265 normal fetus in the second half of gestation assessed by 4D ultrasound using spatio-temporal image correlation

Author Simioni, Christiane Autor UNIFESP Google Scholar
Machado Nardozza, Luciano Marcondes Autor UNIFESP Google Scholar
Araujo Junior, Edward Autor UNIFESP Google Scholar
Rolo, Liliam Cristine Autor UNIFESP Google Scholar
Zamith, Marina Autor UNIFESP Google Scholar
Caetano, Ana Carolina Autor UNIFESP Google Scholar
Moron, Antonio Fernandes Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Abstract Objectives. the aim of this study was to establish nomograms for fetal stroke volume (SV), cardiac output (CO), and ejection fraction (EF) using four-dimensional ultrasound with spatio-temporal image correlation (STIC) modality.Methods. the fetal heart was scanned using STIC modality, starting with classic four-chamber view plane, during fetal quiescence with abdomen uppermost, at an angle of 20-30 degrees, without color Doppler flow mapping. in post-processing virtual organ, computer-aided analysis technique was used to obtain a sequence of six sections of each ventricular volume in end-systolic volume (ESV) and end-diastolic volume (EDV). the SV (SV = EDV-ESV), CO (CO = SV x fetal heart rate), and EF (EF = SV/EDV) for each ventricle were then calculated. Intra- and interobserver agreement were then calculated.Results. Two hundred sixty-five fetuses, ranging in gestational age (GA) from 20 to 34(+6) weeks, were included in the study. the left and right SV and CO increased exponentially with gestation and EF remained fairly stable through gestational. Mean left and right SV increased from 0.211 ml and 0.220 ml at 20 weeks to 1.925 ml and 2.043 ml, respectively, at 34 weeks. Mean left and right CO increased from 30.25 ml/min and 31.52 ml/min at 20 weeks to 268.49 ml/min and 287.80 ml/min, respectively, at 34 weeks. Both left and right mean EF remained constant at around 0.63 with advancing GA. Nomograms were created for LSV, RSV, LCO, RCO, LEF, and REF vs. gestational age. Intra- and interobserver agreement reached 95%.Conclusions. Four-dimensional ultrasound using STIC represents a simple and reproducible method for estimating fetal cardiac function. STIC seems to overcome many of the pitfalls of conventional ultrasound methods and has the potential to become the method of choice.
Keywords 4D ultrasound
stroke volume
cardiac output
ejection fraction
STIC
Language English
Date 2011-09-01
Published in Journal of Maternal-fetal & Neonatal Medicine. London: Informa Healthcare, v. 24, n. 9, p. 1159-1167, 2011.
ISSN 1476-7058 (Sherpa/Romeo, impact factor)
Publisher Informa Healthcare
Extent 1159-1167
Origin http://dx.doi.org/10.3109/14767058.2010.545921
Access rights Closed access
Type Article
Web of Science ID WOS:000294742100017
URI http://repositorio.unifesp.br/handle/11600/34040

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