Assessment of left ventricular filling in normally grown fetuses, growth‐restricted fetuses and fetuses of diabetic mothers

Abstract

There is a delay in left ventricular filling which may reflect changes in myocardial relaxation and possible reduction in passive ventricular filling as a result of chronic hypoxemia in the SGA fetus and altered in utero metabolic environment in the IDDM fetus.

Alternative parameters for echocardiographic assessment of fetal diastolic function

“…The normal E/A ratio during pregnancy is below 1, which means that the fetal myocardium is relatively "stiff" compared to that of newborns and older children (16)(17)(18)(19)(20)(21)(22). An increase or inversion of the E/A ratio is related to ventricular diastolic dysfunction (23)(24)(25)(26)(27). There are few reports of other parameters used to evaluate ventricular diastolic function in the fetus.…”

Fluxo no ducto venoso e hipertrofia miocárdica em fetos de mães diabéticas

“…According to Tsyvian et al 12 , in addition to myocardial hypertrophy in fetuses of diabetic mothers, an alteration in left ventricular filling occurs between the 20th and 36th gestational weeks. Left ventricular filling depends on myocardial diastole and is modified by several factors.…”

“…Rizzo et al 13 reported a reduction in diastolic function in fetuses of diabetic mothers expressed by this ratio. A reduced ventricular compliance in fetuses of diabetic mothers could be secondary to wall thickening or to other factors, such as metabolic alterations in the uterine environment associated with qualitative changes in collagen (an increase in the fluorescent collagen in the myocardium) 12 . The higher E wave velocity in mitral and tricuspid valves in the group of fetuses of diabetic mothers with myocardial hypertrophy found in this study could reflect an altered pattern of relaxation.…”

“…Alterations in left ventricular filling, depending or not on myocardial hypertrophy, have been reported between the 20th and 36th gestational weeks 12 . The studies aimed to assess fetal diastolic function have used analysis of the E/A ratio of mitral and tricuspid flows 12,13 .…”

“…The studies aimed to assess fetal diastolic function have used analysis of the E/A ratio of mitral and tricuspid flows 12,13 .…”