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dc.contributor.authorHerling, Lotta
dc.contributor.authorJohnson, Jonas
dc.contributor.authorFerm-Widlund, Kjerstin
dc.contributor.authorBergholm, Fredrik
dc.contributor.authorElmstedt, Nina
dc.contributor.authorLindgren, Peter
dc.contributor.authorSonesson, Sven-Erik
dc.contributor.authorAcharya, Ganesh
dc.contributor.authorWestgren, Magnus
dc.date.accessioned2020-01-15T12:53:18Z
dc.date.available2020-01-15T12:53:18Z
dc.date.issued2018-02-26
dc.description.abstract<i>Objectives</i> - Color tissue Doppler imaging (cTDI) is a promising tool for the assessment of fetal cardiac function. However, the analysis of myocardial velocity traces is cumbersome and time‐consuming, limiting its application in clinical practice. The aim of this study was to evaluate fetal cardiac function during the second half of pregnancy and to develop reference ranges using an automated method to analyze cTDI recordings from a cardiac four‐chamber view.<p> <p><i>Methods</i> - This was a cross‐sectional study including 201 normal singleton pregnancies between 18 and 42 weeks of gestation. During fetal echocardiography, a four‐chamber view of the heart was visualized and cTDI was performed. Regions of interest were positioned at the level of the atrioventricular plane in the left ventricular (LV), right ventricular (RV) and septal walls of the fetal heart, to obtain myocardial velocity traces that were analyzed offline using the automated algorithm. Peak myocardial velocities during atrial contraction (Am), ventricular ejection (Sm) and rapid ventricular filling, i.e. early diastole (Em), as well as the Em/Am ratio, mechanical cardiac time intervals and myocardial performance index (cMPI) were evaluated, and gestational age‐specific reference ranges were constructed.<p> <p><i>Results</i> - At 18 weeks of gestation, the peak myocardial velocities, presented as fitted mean with 95% CI, were: LV Am, 3.39 (3.09–3.70) cm/s; LV Sm, 1.62 (1.46–1.79) cm/s; LV Em, 1.95 (1.75–2.15) cm/s; septal Am, 3.07 (2.80–3.36) cm/s; septal Sm, 1.93 (1.81–2.06) cm/s; septal Em, 2.57 (2.32–2.84) cm/s; RV Am, 4.89 (4.59–5.20) cm/s; RV Sm, 2.31 (2.16–2.46) cm/s; and RV Em, 2.94 (2.69–3.21) cm/s. At 42 weeks of gestation, the peak myocardial velocities had increased to: LV Am, 4.25 (3.87–4.65) cm/s; LV Sm, 3.53 (3.19–3.89) cm/s; LV Em, 4.55 (4.18–4.94) cm/s; septal Am, 4.49 (4.17–4.82) cm/s; septal Sm, 3.36 (3.17–3.55) cm/s; septal Em, 3.76 (3.51–4.03) cm/s; RV Am, 6.52 (6.09–6.96) cm/s; RV Sm, 4.95 (4.59–5.32) cm/s; and RV Em, 5.42 (4.99–5.88) cm/s. The mechanical cardiac time intervals generally remained more stable throughout the second half of pregnancy, although, with increased gestational age, there was an increase in duration of septal and RV atrial contraction, LV pre‐ejection and septal and RV ventricular ejection, while there was a decrease in duration of septal postejection. Regression equations used for the construction of gestational age‐specific reference ranges for peak myocardial velocities, Em/Am ratios, mechanical cardiac time intervals and cMPI are presented.<p> <p><i>Conclusion</i> - Peak myocardial velocities increase with gestational age, while the mechanical time intervals remain more stable throughout the second half of pregnancy. Using an automated method to analyze cTDI‐derived myocardial velocity traces, it was possible to construct reference ranges, which could be used in distinguishing between normal and abnormal fetal cardiac function.en_US
dc.descriptionThis is the pre-peer reviewed version of the following article: Herling, L., Johnse, J., Ferm-Widlund, K., Bergholm, F., Elmstedt, N, Lindgren, P. ... Westgren, M. (2018). Automated analysis of fetal cardiac funcion using color tissue Doppler imaging in second half of normal pregnancy. <i>Ultrasound in Obstetrics & Gynecology, 53</i>(3), 348-357, which has been published in final form at <a href=https://doi.org/10.1002/uog.19037>https://doi.org/10.1002/uog.19037</a>. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.en_US
dc.identifier.citationHerling L, Johnson J, Ferm-Widlund K, Bergholm F, Elmstedt, Lindgren P, Sonesson S, Acharya G, Westgren M. Automated analysis of fetal cardiac function using color tissue Doppler imaging in second half of normal pregnancy. Ultrasound in Obstetrics and Gynecology. 2019;53(3):348-357en_US
dc.identifier.cristinIDFRIDAID 1711773
dc.identifier.doi10.1002/uog.19037
dc.identifier.issn0960-7692
dc.identifier.issn1469-0705
dc.identifier.urihttps://hdl.handle.net/10037/17103
dc.language.isoengen_US
dc.publisherWileyen_US
dc.relation.journalUltrasound in Obstetrics and Gynecology
dc.rights.accessRightsopenAccessen_US
dc.rights.holderCopyright © 2018 ISUOG. Published by John Wiley & Sons Ltd.en_US
dc.subjectVDP::Medical disciplines: 700en_US
dc.subjectVDP::Medisinske Fag: 700en_US
dc.titleAutomated analysis of fetal cardiac function using color tissue Doppler imaging in second half of normal pregnancyen_US
dc.type.versionsubmittedVersionen_US
dc.typeJournal articleen_US
dc.typeTidsskriftartikkelen_US
dc.typePreprinten_US
dc.typeManuskripten_US


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