Objective: To explore the characteristics of intra-cardiac blood cysts to provide a reference for accurate diagnosis and prognosis. Methods: In this study, 8 cases of cardiac blood cysts were analyzed retrospectively from January 2006 to March 2020, and the clinical symptoms, echocardiography, operation and prognosis were analyzed. Results: All clinical symptoms were not typical and cysts were isolated. The cysts were attached to the anterior leaflet of the mitral valve (n=4), posterior papillary muscle and chordae of mitral valve (n=1), septal leaflet of the tricuspid valve (n=2), or the tricuspid valve orifice and tricuspid anterior annulus (n=1). Echocardiography revealed the cysts were small and balloon-like. They had high tension wall, the wall was thin and smooth. Calcification could be seen on the cyst wall. The inside was none echogenicity area and the cyst moved and swung with the valve or chordae. Of the 8 patients, 1 had no hemodynamic effects and did not need surgery. The other 7 cases were confirmed by surgery and pathology for the cardiac blood cysts. 3 subjects underwent simple cystectomy alone. 1 with infectious endocarditis and mitral valve vegetation, and the other one caused the left ventricular outflow tract obstruction. 2 subjects had a history of mitral valve abnormality with mechanical mitral valve replacement. Conclusions: Cardiac blood cysts are rare and benign heart condition in adults. They can be diagnosed by echocardiography to guide intervention.
Background: Current studies have confirmed that fetal congenital heart diseases (CHDs) are caused by various factors. However, the quantitative risk of CHD is not clear given the combined effects of multiple factors. Objective: This cross-sectional study aimed to detect associated factors of fetal CHD using a Bayesian network in a large sample and quantitatively analyze relative risk ratios (RRs). Methods: Pregnant women who underwent fetal echocardiography (N = 16,086 including 3,312 with CHD fetuses) were analyzed. Twenty-six maternal and fetal factors were obtained. A Bayesian network is constructed based on all variables through structural learning and parameter learning methods to find the environmental factors that directly and indirectly associated with outcome, and the probability of fetal CHD in the two groups is predicted through a junction tree reasoning algorithm, so as to obtain RR for fetal CHD under different exposure factor combinations. Taking into account the effect of gestational week on the accuracy of model prediction, we conducted sensitivity analysis on gestational week groups. Results: The single-factor analysis showed that the RRs for the numbers of births, spontaneous abortions, and parental smoking were 1.50, 1.38, and 1.11 (P < 0.001), respectively. The risk gradually increased with the synergistic effect of ranging from one to more environmental factors above. The risk was higher among subjects with five synergistic factors, including the number of births, upper respiratory tract infection during early pregnancy, anemia, and mental stress as well as a history of spontaneous abortions or parental smoking, than in those with less than 5 factors (RR = 2.62 or 2.28, P < 0.001). This result was consistent across the participants grouped by GWs. Conclusion: We identified six factors that were directly associated with fetal CHD. A higher number of these factors led to a higher risk of CHD. These findings suggest that it is important to strengthen healthcare and prenatal counseling for women with these factors.
BackgroundPremature ductus arteriosus constriction (DA Con) can result in right ventricular enlargement, right ventricular hypertrophy, and tricuspid regurgitation.MethodThis study retrospectively analyzed 34 singleton fetuses that underwent fetal echocardiography with a diagnosis of DA Con (16 cases with mild to moderate, and 18 cases with moderate to severe) and 45 healthy fetuses. The morphology and function parameters of cardiac, as well as the 24-Segment of ventricles, were compared between the DA Con group and controls, and between the mild to moderate and moderate to severe groups, using the fetal heart quantification (FHQ) technology.ResultsThere were no significant difference in left ventricular parameters in DA Con group when compared to controls. Moreover, fetal 4CV-GSI was significantly reduced, as well as the sphericity index (SI), fractional shortening (FS), global longitudinal strain (GS) and fractional area change (FAC) of right ventricle, especially in the basal-middle segments. Compared with the mild to moderate group, LV-FS increased and RV-FS decreased in moderate to severe group.ConclusionThe results showed that the fetal heart in the DA Con group was different from the controls in morphology and function. FHQ technology provides a comprehensive assessment for the evaluation of cardiac morphological and functional changes in DA Con fetuses.
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