Department of Obstetrics, Paulista School of Medicine - Federal University of São Paulo (EPM-UNIFESP), Rua Belchior de Azevedo, 156 apto. 111 Torre Vitoria, São Paulo, SP, CEP 05089-030, Brazil.
Mario Palmério University Hospital - University of Uberaba (UNIUBE), Uberaba, MG, Brazil.
Int J Cardiovasc Imaging. 2021 Sep;37(9):2717-2726. doi: 10.1007/s10554-021-02239-7. Epub 2021 Apr 12.
To establish reference values for the systolic-to-diastolic duration ratio (SDR) of the left ventricle (LV) using spectral Doppler, as well as for the SDR' of the interventricular septum (SEP), LV, and right ventricles (RV) using tissue Doppler of the fetal heart.
This prospective and cross-sectional study evaluated 374 low-risk singleton pregnancies from 20 to 36 + 6 weeks of gestation. The ventricular filling time (FT) was obtained from LV inflow using spectral Doppler. Tissue Doppler was used to assess the FT of each ventricle by placing the cursor at the atrioventricular junction marked by the mitral and tricuspid valves, respectively. SDR was calculated as the sum of the isovolumic contraction time (ICT) and the ejection time (ET) divided by the sum of the isovolumic relaxation time (IRT) and the ventricular FT. We used regression analysis to obtain the best-fit model polynomial equation for the parameters. The concordance correlation coefficient (CCC) was used to assess intra- and inter-observer reproducibility.
SDR and SDR' LV showed a progressive decrease with gestational age (GA); the SDR' RV and SDR' SEP did not show a significant decrease with advancing GA. The SDR LV (r = 0.29, p < 0.0001), SDR' RV (r = 0.21, p < 0.0001), SDR' LV (r = 0.20, p = 0.0001), and SDR' SEP (r = 0.25, p < 0.0001) showed a significant weak positive correlation with fetal heart rate. The inter-observer SDR' SEP measurements demonstrated poor reproducibility (CCC: 0.50), whereas intra-observer SRD LV measurements demonstrated moderate reproducibility (CCC: 0.78).
Reference values for SDR SEP, LV, and RV using spectral and tissue Doppler of fetal heart were established between 20 and 36+6 weeks of gestation.
利用频谱多普勒建立胎儿左心室（LV）收缩期与舒张期持续时间比值（SDR）以及室间隔（SEP）、LV 和右心室（RV）组织多普勒 SDR'的参考值。
本前瞻性和横断面研究评估了 20 至 36+6 孕周的 374 例低危单胎妊娠。LV 采用频谱多普勒获取心室充盈时间（FT）。采用组织多普勒，在二尖瓣和三尖瓣标记的房室结处放置光标，分别评估每个心室的 FT。SDR 计算为等容收缩时间（ICT）和射血时间（ET）之和除以等容舒张时间（IRT）和心室 FT 之和。我们使用回归分析得到参数的最佳拟合多项式方程。采用一致性相关系数（CCC）评估观察者内和观察者间的可重复性。
随着胎龄（GA）的增加，SDR 和 SDR'LV 呈逐渐下降趋势；SDR'RV 和 SDR'SEP 与 GA 的增加无显著下降。SDR LV（r=0.29，p<0.0001）、SDR' RV（r=0.21，p<0.0001）、SDR' LV（r=0.20，p=0.0001）和 SDR' SEP（r=0.25，p<0.0001）与胎儿心率呈显著弱正相关。SEP 的观察者间 SDR'测量重复性差（CCC：0.50），而 LV 的观察者内 SDR 测量重复性中等（CCC：0.78）。
在 20 至 36+6 孕周期间，建立了胎儿心脏频谱和组织多普勒 SDR SEP、LV 和 RV 的参考值。
