Aortic Intima-Media Thickness and Aortic Diameter in Small for Gestational Age and Growth Restricted Fetuses

Gómez‐Roig, M.; Mazarico, Edurne; Valladares, Esther; Guirado, L.; Fernandez-Arias, Mireia; Vela, Antonio

doi:10.1371/journal.pone.0126842

Cited by 29 publications

(26 citation statements)

References 14 publications

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“…The intima-media thickness (IMT) and the stiffness of the abdominal aorta by means of ultrasound examination are the most promising non-invasive biomarkers of adverse cardiovascular remodeling in fetuses and newborns [3,[6][7][8][9][10][11][12]. Fetal aortic IMT might be related to inflammation, probably indicating a very early stage of future atherosclerosis in adulthood [13].…”

Section: Introductionmentioning

confidence: 99%

Real-time diameter of the fetal aorta from ultrasound

Savioli

Grisan

Visentin

et al. 2019

Neural Comput & Applic

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The automatic analysis of ultrasound sequences can substantially improve the efficiency of clinical diagnosis. This article presents an attempt to automate the challenging task of measuring the vascular diameter of the fetal abdominal aorta from ultrasound images. We propose a neural network architecture consisting of three blocks: a convolutional neural network (CNN) for the extraction of imaging features, a convolution gated recurrent unit (C-GRU) for exploiting the temporal redundancy of the signal, and a regularized loss function, called CyclicLoss, to impose our prior knowledge about the periodicity of the observed signal. The solution is investigated with a cohort of 25 ultrasound sequences acquired during the third-trimester pregnancy check, and with 1000 synthetic sequences. In the extraction of features, it is shown that a shallow CNN outperforms two other deep CNNs with both the real and synthetic cohorts, suggesting that echocardiographic features are optimally captured by a reduced number of CNN layers. The proposed architecture, working with the shallow CNN, reaches an accuracy substantially superior to previously reported methods, providing an average reduction of the mean squared error from 0.31 (state-of-the-art) to 0.09 mm 2 , and a relative error reduction from 8.1 to 5.3%. The mean execution speed of the proposed approach of 289 frames per second makes it suitable for real-time clinical use. Nicoló Savioli and Enrico Grisan equally contributed to the work.

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Section: Introductionmentioning

confidence: 99%

Real-time diameter of the fetal aorta from ultrasound

Savioli

Grisan

Visentin

et al. 2019

Neural Comput & Applic

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“…Low birth weight and Doppler abnormalities in IUGR have been proposed to alter vascular structure causing possible endothelial damage [5]. Interestingly, a higher median aortic wall intima-media thickening has been shown in IUGR compared to SGA fetuses as a potential sign of preclinical atherosclerosis, which might predispose these individuals to later cardiovascular disease [10] and which underlines the importance to clearly differentiate between IUGR and SGA.…”

Section: Discussionmentioning

confidence: 99%

Intrauterine Growth Restriction (IUGR) Induces Signs of Subclinical Atherosclerosis in 6-Year-Old Infants Despite Absence Of Excessive Growth

et al. 2017

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Postnatal catch-up growth and rapid weight gain after intrauterine growth restriction (IUGR) seem to increase the risk for later disease. This study aimed to compare features of the metabolic syndrome early in life between IUGR and appropriate for gestational age (AGA) infants. Data for 9 infants with IUGR defined by a birth weight<10 percentile and ultrasound-proven placental insufficiency and 11 AGA children were available. Postnatal growth, auxological, cardiovascular, and metabolic parameters up to a chronological age of 6 years were assessed: Fasting serum concentrations of LDL-cholesterol, insulin, leptin, IGF-I, DHEAS, skinfold thicknesses, blood pressure, and mean carotid intima-media thickness (cIMT). All IUGR infants showed catch-up growth, although mean BMI SDS and total subcutaneous fat mass at the age of 6 years were still slightly lower compared to the AGA cohort. Reduced serum leptin concentrations were observed in IUGR infants (p=0.02), whereas no significant difference was found for IGF-I, insulin, LDL-cholesterol and DHEAS concentrations. Mean cIMT was significantly higher in IUGR infants (p<0.05). Mean arterial pressure did no differ. In 6-year-old IUGR infants with catch-up growth, who still had a slightly reduced BMI SDS compared to the AGA group, signs of subclinical atherosclerosis were detectable suggesting that cardiovascular risk in IUGR may be present even in the absence of excessive growth.

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“…Arterial distensibility is commonly measured as the relative systolic increase in arterial volume, and reflects the mechanical load placed on the arterial wall, while compliance refers to the unit change in volume induced by a unit change in pressure, and reflects the artery's ability to store volume thus limiting pressure rises (buffering function) . In addition to arterial elasticity, intima‐media thickness (IMT) of the abdominal aorta is also a well‐established marker for CVD risk in young adults and children …”

Section: Introductionmentioning

confidence: 99%

“…[18][19][20] In addition to arterial elasticity, intima-media thickness (IMT) of the abdominal aorta is also a well-established marker for CVD risk in young adults and children. [21][22][23][24] To date, there is little research describing distal abdominal aorta compliance and distensibility in fetuses, in general, and especially in those exposed to maternal diabetes. Hu and co-authors 25 reported differences in pulse wave velocity (PWV), an indirect measure of elasticity, between fetuses of insulin-dependent diabetic mothers and fetuses of non-diabetic mothers.…”

Section: Introductionmentioning

confidence: 99%

Assessing vascular characteristics of the fetal descending aorta: A feasibility study

Evanoff

Dengel

Narasimhan

2020

J of Clinical Ultrasound

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Research describing fetal arterial structure and function is lacking within the literature. This study's purpose was to measure intima‐media thickness (IMT), compliance and distensibility of 24‐ to 25‐week fetuses' abdominal aortas using conventional ultrasonography from 16 diabetic (DM) and 25 non‐diabetic mothers (NDM). We found no significant differences in fetal abdominal aorta IMT (P = .68), diameter distensibility (P = .22), or cross‐sectional distensibility (P = .23). However, both fetal abdominal aortic diameter compliance (P = .03) and cross‐sectional compliance (P = .005) were greater in DM than in NDM (P = .005). This study demonstrates that it is possible and potentially useful to measure fetal abdominal aorta biometrics and biomechanical characteristics.

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Aortic Intima-Media Thickness and Aortic Diameter in Small for Gestational Age and Growth Restricted Fetuses

Cited by 29 publications

References 14 publications

Real-time diameter of the fetal aorta from ultrasound

Real-time diameter of the fetal aorta from ultrasound

Intrauterine Growth Restriction (IUGR) Induces Signs of Subclinical Atherosclerosis in 6-Year-Old Infants Despite Absence Of Excessive Growth

Assessing vascular characteristics of the fetal descending aorta: A feasibility study

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