Department of Perinatology, University of Health Sciences Tepecik Training and Research Hospital, Izmir, Turkey.
Department of Obstetrics and Gynecology, University of Health Sciences Tepecik Training and Research Hospital, Izmir, Turkey.
Int J Cardiovasc Imaging. 2023 May;39(5):907-914. doi: 10.1007/s10554-022-02789-4. Epub 2023 Jan 6.
This study aims to evaluate cardiac function in cases of intrahepatic cholestasis of pregnancy (ICP) and compare results with those from healthy controls using the fetal left ventricular modified myocardial performance index (LMPI) and E-wave/A-wave peak velocities (E/A ratio). Moreover, the association between LMPI values, total bile acid (TBA) levels, fetal Doppler measurements, and adverse neonatal outcomes was evaluated. A prospective cross-sectional study of 120 pregnant women was conducted, with 60 having ICP and the other 60 serving as controls. Doppler ultrasound and two-dimensional gray-scale fetal echocardiography were used to calculate the LMPI values and E/A ratios, respectively. The association between LMPI values and TBA levels, fetal Doppler measurements, and adverse neonatal outcomes was evaluated. Fetal LMPI values were significantly higher in the ICP group than in the control group (0.54 ± 0.54 vs. 0.44 ± 0.03; p < 0.001), but the E/A ratio was similar in both groups (0.69 ± 0.10 vs. 0.66 ± 0.14; p = 0.203). TBA levels were positively and significantly correlated with LMPI values (r = 0.546, p < 0.01); however, no significant correlation was found between umbilical arterial pulsatility index values and LMPI values (r = 0.071, p > 0.01). LMPI values were not associated with adverse neonatal outcomes in ICP cases. Fetal cardiac function (LMPI) is associated with increased bile acid levels in ICP. However, because it was not associated with adverse neonatal outcomes in ICP cases, the clinical significance of this finding is unclear. Further studies are required to evaluate the implications of increased LMPI.
本研究旨在评估妊娠期肝内胆汁淤积症（ICP）患者的心脏功能，并通过胎儿左心室改良心肌做功指数（LMPI）和 E 波/A 波峰值速度（E/A 比值）将结果与健康对照组进行比较。此外，还评估了 LMPI 值、总胆汁酸（TBA）水平、胎儿多普勒测量值与不良新生儿结局之间的相关性。对 120 例孕妇进行前瞻性横断面研究，其中 60 例为 ICP 患者，60 例为对照组。采用多普勒超声和二维灰阶胎儿超声心动图分别计算 LMPI 值和 E/A 比值。评估 LMPI 值与 TBA 水平、胎儿多普勒测量值与不良新生儿结局之间的相关性。ICP 组胎儿 LMPI 值明显高于对照组（0.54±0.54 比 0.44±0.03；p<0.001），但两组 E/A 比值相似（0.69±0.10 比 0.66±0.14；p=0.203）。TBA 水平与 LMPI 值呈正相关（r=0.546，p<0.01），但脐动脉搏动指数值与 LMPI 值无明显相关性（r=0.071，p>0.01）。在 ICP 病例中，LMPI 值与不良新生儿结局无关。胎儿心脏功能（LMPI）与 ICP 中胆汁酸水平升高有关。然而，由于它与 ICP 病例的不良新生儿结局无关，因此其临床意义尚不清楚。需要进一步研究来评估增加 LMPI 的意义。
