Peixoto Alberto Borges, Bravo-Valenzuela Nathalie Jeanne, Martins Wellington P, Mattar Rosiane, Moron Antonio Fernandes, Araujo Júnior Edward
Department of Obstetrics, Paulista School of Medicine - Federal University of São Paulo (EPM-UNIFESP).
SEMEAR Fertilidade, Reproductive Medicine.
Med Ultrason. 2019 Aug 31;21(3):279-287. doi: 10.11152/mu-1945.
To establish reference range values for peak myocardial tissue Doppler velocity (MTD) and myocardial performance index (MPI) of the left ventricle (LV), the right ventricle (RV), and the interventricular septum (IVS) at 20 to 36+6 weeks of gestation using spectral tissue Doppler.
This cross-sectional study was conducted among 360 lowrisk singleton pregnancies. MTD during systole (S'), and early (E') and late diastole (A'), and MPI' were assessed by placing sample volume at the basal segment of the LV free wall, the RV free wall, and the IVS, respectively. Polynomial regression was used to obtain the best-fit curves for MTD and MPI' measurements as a function of gestational age (GA), and adjustments were made using the determination coefficient (R2). Intra- and inter-observer reproducibility was evaluated using the concordance correlation coefficient (CCC).
All MTD velocities (cm/s) progressively increased with advancing GA (p<0.0001). Mean LV MTD values were 4.19 to 6.86 for S', 3.52 to 7.22 for E', and 6.85 to 9.19 for A'; mean RV MTD were 4.85 to 7.97 for S', 4.49 to 8.66 for E', and 8.44 to 11.20 for A'; and mean IVS MTD values were 3.75 to 5.78 for S', 3.34 to 5.79 for E', and 5.88 to 7.98 for A'. LV MPI', RV MPI', and IVS MPI' did not significantly change with advancing GA. The CCC values for MTD were predominantly greater than 0.70, while those for MPI' were <0.70.
Reference values for the fetal MTD and MPI' of RV, LV and IVS using tissue Doppler between 20 and 36+6 weeks of gestation were described.
使用频谱组织多普勒技术建立妊娠20至36⁺⁶周时左心室（LV）、右心室（RV）和室间隔（IVS）的心肌组织多普勒峰值速度（MTD）和心肌性能指数（MPI）的参考范围值。
本横断面研究在360例低风险单胎妊娠中进行。通过分别将取样容积置于左心室游离壁、右心室游离壁和室间隔的基底段，评估收缩期（S'）、舒张早期（E'）和舒张晚期（A'）的MTD以及MPI'。使用多项式回归获得MTD和MPI'测量值作为胎龄（GA）函数的最佳拟合曲线，并使用决定系数（R²）进行调整。使用一致性相关系数（CCC）评估观察者内和观察者间的可重复性。
所有MTD速度（cm/s）均随着胎龄增加而逐渐升高（p<0.0001）。左心室MTD的平均S'值为4.19至6.86，E'值为3.52至7.22，A'值为6.85至9.19；右心室MTD的平均S'值为4.85至7.97，E'值为4.49至8.66，A'值为8.44至11.20；室间隔MTD的平均S'值为3.75至5.78，E'值为3.34至5.79，A'值为5.88至7.98。左心室MPI'、右心室MPI'和室间隔MPI'并未随胎龄增加而显著变化。MTD的CCC值主要大于0.70，而MPI'的CCC值小于0.70。
描述了妊娠20至36⁺⁶周期间使用组织多普勒技术测量胎儿右心室、左心室和室间隔的MTD和MPI'的参考值。
