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Fetal colour tissue Doppler imaging (cTDI): biventricular reference ranges for the time segments of the cardiac cycle in second and third trimesters of gestation

  • Maternal-Fetal Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

To construct biventricular reference ranges for isovolumic time intervals (isovolumic contraction time, ICT; isovolumic relaxation time, IRT) and ejection time (ET) for colour tissue Doppler imaging (cTDI) between 15 and 37 weeks’ in healthy fetuses.

Methods

This was a prospective multicentre cross-sectional study involving 160 singleton pregnancies between 15 and 37 weeks of gestation, using cTDI. ICT, ET, IRT and myocardial performance index (MPI) were analysed offline using a small region of interest (ROI) within the basal part of the right and left ventricular wall immediately distal to the annulus. Regression analysis was used to determine gestational age-adjusted reference ranges and to construct nomograms for cTDI parameters.

Results

Right and left ventricular ICT (p = 0.004 and p < 0.001) and ET (p = 0.011 and p = 0.050) increased, whereas IRT (p = 0.862 and p = 0.067) and MPI (p = 0.476 and p = 0.777) remained constant with gestational age.

Conclusions

This is the first study to evaluate fetal isovolumic time intervals in the second and third trimesters of gestation using cTDI. Normal data for fetal isovolumic time intervals and biventricular MPI by colour tissue Doppler imaging are provided. The reference ranges may be useful in research or clinical studies and can be used in fetuses with compromised cardiac function.

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Acknowledgments

This study was funded by a grant from the German Society of Ultrasound in Medicine (Deutsche Gesellschaft für Ultraschall in der Medizin, DEGUM). Technical support was provided by Toshiba Medical Systems Corporation, Otawara-Shi, Tochigi, Japan.

Author information

Authors and Affiliations

  1. Department of Obstetrics and Prenatal Medicine, University of Bonn, Sigmund-Freud-Strasse 25, 53105, Bonn, Germany

    Arne Willruth & Ulrich Gembruch

  2. Department of Fetal Cardiology, Heart and Diabetes Centre North Rhine-Westphalia, Bad Oeynhausen, Ruhr-University Bochum, Bochum, Germany

    Johannes Steinhard

  3. Institute of Prenatal Medicine, Obstetrics and Gynecology, University Giessen and Marburg, Marburg, Germany

    Christian Enzensberger & Roland Axt-Fliedner

  4. Toshiba Medical Systems Europe, Neuss, Germany

    Astrid Doelle & Willem Gorissen

  5. Department for Medical Biometry, Informatics and Epidemiology, University of Bonn, Bonn, Germany

    Rolf Fimmers

  6. Department of Obstetrics and Gynecology, Bürgerhospital, Frankfurt, Germany

    Franz Bahlmann

Authors
  1. Arne Willruth
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  2. Johannes Steinhard
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  3. Christian Enzensberger
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  4. Roland Axt-Fliedner
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  5. Ulrich Gembruch
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  6. Astrid Doelle
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  7. Willem Gorissen
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  8. Rolf Fimmers
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  9. Franz Bahlmann
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Corresponding author

Correspondence to Arne Willruth.

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Conflict of interest

The authors AW, JS, CE, RA, UG, RF and FB declare that they have no conflict of interest. The co-authors AD and WG worked for Toshiba Medical Systems Corporation, Otawara-Shi, Tochigi, Japan and provided technical support.

Ethical approval

All procedures performed in our study were in accordance with the ethical standards of the institutional (study protocol 253/11) and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Written Informed consent was obtained from all individual participants included in the study.

Additional information

On behalf of the Fetal Cardiac Imaging Research Group Germany.

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Willruth, A., Steinhard, J., Enzensberger, C. et al. Fetal colour tissue Doppler imaging (cTDI): biventricular reference ranges for the time segments of the cardiac cycle in second and third trimesters of gestation. Arch Gynecol Obstet 294, 917–924 (2016). https://doi.org/10.1007/s00404-016-4076-z

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  • DOI: https://doi.org/10.1007/s00404-016-4076-z

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