Christine B. Falkensammer, James Paul, James C. Huhta
Fetal congestive heart failure: correlation of Tei-Index and Cardiovascular-Score
Introduction: Congestive heart failure (CHF) may be
present in fetuses with hydrops fetalis (HF) and the severity
is difficult to quantitate. Differential ventricular
dysfunction may be present in the fetus with CHF. A
non-geometric measure of ventricular function that is
not afterload dependent would be useful to measure the
severity of myocardial dysfunction.
Methods: Tei-index (isovolumetric time/ejection time)
was measured prenatally in 23 normals (24–34 weeks
gestational age-GA) and in 7 with HF (24–34 weeks
GA). Prenatal CHF severity was graded by a 10 point
cardiovascular (CV) score (2 points each for absence of
hydrops, normal venous Doppler, heart function, arterial
Doppler, and heart size, and 10/10 = normal). A paired
student t-test was used to compare RV and LV and nonpaired
t-test compared HF and normals. Tei-index and
CV score were correlated.
Results: Tei-index normals were 0.38 ± 0.04 in the
right ventricle (RV) and 0.41 ± 0.05 in the left ventricle
(LV) and there were no significant RV-LV or gestational
age (GA) differences. Among HF fetuses, RV and LV
Tei-indices were both significantly increased (0.54 and
0.92) and not significantly different. CV score ranged
from 2 to 8 (mean 5.43 out of 10) and correlated inversely
with Tei-index (r = ?0.52, r = ?0.68).
Conclusion: Hydrops fetalis is associated with biventricular
dysfunction and congestive heart failure. Tei-index correlates with CV score obtained within two weeks
of delivery or intrauterine death. Tei-index may be useful
in the serial assessment of myocardial dysfunction
in the fetus with hydrops.
Journal of Perinatal Medicine, Walter de Gruyter
Print ISSN: 1619-3997
Volume: 29, 11/2001
Pages: 390 - 398
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