Fetal Medicine Mexico, Fetal Surgery Research Unit, Children and Women's Specialty Hospital; Unidad de Investigación en Neurodesarrollo, Instituto de Neurobiología, Universidad Nacional Autónoma de México (UNAM) Campus Juriquilla, Juriquilla, Queretaro, Mexico.
BCNatal-Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Deu), Institut d'Investigacions Biomèdiques August Pi i Sunyer, Universitat de Barcelona and Centre for Biomedical Research on Rare Diseases (CIBER-ER), Barcelona, Spain.
Prenat Diagn. 2018 May;38(6):422-427. doi: 10.1002/pd.5253. Epub 2018 Apr 15.
To evaluate cardiac function by conventional echocardiography and tissue Doppler imaging in fetuses with left congenital diaphragmatic hernia (CDH).
Conventional echocardiography (myocardial performance index, ventricular filling velocities, and E/A ratios) and tissue Doppler imaging (annular myocardial peak velocities, E/E' and E'/A' ratios) in mitral, septal, and tricuspid annulus were evaluated in a cohort of 31 left-sided CDH fetuses and compared with 75 controls matched for gestational age 2:1.
In comparison to controls, CDH fetuses had prolonged isovolumetric time periods (isovolumetric contraction time 35 ms vs 28 ms, P < .001), with higher myocardial performance index (0.49 vs 0.42, P < .001) and tricuspid E/A ratios (0.77 vs 0.72, P = .033). Longitudinal function assessed by tissue Doppler showed signs of impaired relaxation (mitral lateral A' 8.0 vs 10.1 cm/s, P < .001 and an increased mitral lateral E'/A' ratio 0.93 vs 0.78, P < .001) in the CDH fetuses as compared with controls, with preserved systolic function.
Left CDH fetuses show echocardiographic signs of diastolic dysfunction, probably secondary to fetal heart compression, maintaining a preserved systolic function.
通过常规超声心动图和组织多普勒成像评估左侧先天性膈疝（CDH）胎儿的心脏功能。
评估了 31 例左侧 CDH 胎儿和 75 例按 2:1 年龄匹配的对照组的常规超声心动图（心肌做功指数、心室充盈速度和 E/A 比值）和组织多普勒成像（二尖瓣、室间隔和三尖瓣环的环状心肌峰值速度、E/E'和 E'/A'比值）。
与对照组相比，CDH 胎儿等容收缩时间延长（35 毫秒比 28 毫秒，P<0.001），心肌做功指数较高（0.49 比 0.42，P<0.001），三尖瓣 E/A 比值较高（0.77 比 0.72，P=0.033）。组织多普勒评估的纵向功能显示舒张功能障碍的迹象（二尖瓣侧壁 A' 8.0 比 10.1cm/s，P<0.001，二尖瓣侧壁 E'/A' 比值增加 0.93 比 0.78，P<0.001），与对照组相比，CDH 胎儿收缩功能正常。
左侧 CDH 胎儿表现出舒张功能障碍的超声心动图迹象，可能是胎儿心脏受压引起的，同时保持收缩功能正常。
