Doppler in Fetal Heart Failure

Huhta, James C.; Paul, James J.

doi:10.1097/grf.0b013e3181fdffd9

Cited by 42 publications

(26 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However, sustained fetal arrhythmias may result in fetal congestive heart failure and hydrops, even death [2–5]. With the rapid development of fetal echocardiography, accurate prenatal diagnosis for some types of fetal arrhythmia and heart dysfunction can be achieved [6] in collaboration with multiple evaluation systems [7–9].…”

Section: Introductionmentioning

confidence: 99%

The Study of Fetal Rat Model of Intra-Amniotic Isoproterenol Injection Induced Heart Dysfunction and Phenotypic Switch of Contractile Proteins

Fang

Hua

et al. 2014

BioMed Research International

View full text Add to dashboard Cite

To establish a reliable isoproterenol induced heart dysfunction fetal rat model and understand the switches of contractile proteins, 45 pregnant rats were divided into 15 mg/kg-once, 15 mg/kg-twice, sham-operated once, sham-operated twice, and control groups. And 18 adult rats were divided into isoproterenol-treated and control groups. H&E staining, Masson staining, and transmission electron microscope were performed. Apoptotic rate assessed by TUNEL analysis and expressions of ANP, BNP, MMP-2, and CTGF of hearts were measured. Intra-amniotic injections of isoproterenol were supplied on E14.5 and E15.5 for fetuses and 7-day continuous intraperitoneal injections were performed for adults. Then echocardiography was performed with M-mode view assessment on E18.5 and 6 weeks later, respectively. Isoproterenol twice treated fetuses exhibited significant changes in histological evaluation, and mitochondrial damages were significantly severe with increased apoptotic rate. ANP and BNP increased and that of MMP-2 increased in isoproterenol twice treated group compared to control group, without CTGF. The isoforms transition of troponin I and myosin heavy chain of fetal heart dysfunction were opposite to adult procedure. The administration of intra-amniotic isoproterenol to fetal rats could induce heart dysfunction and the regulation of contractile proteins of fetuses was different from adult procedure.

show abstract

Section: Introductionmentioning

confidence: 99%

The Study of Fetal Rat Model of Intra-Amniotic Isoproterenol Injection Induced Heart Dysfunction and Phenotypic Switch of Contractile Proteins

Fang

Hua

et al. 2014

BioMed Research International

View full text Add to dashboard Cite

show abstract

“…The prognosis of some forms of fetal heart failure can be assessed with the cardiovascular profile (CVP) score 244 ( Table 8). Scoring of the 5 categories (2 points for each), including hydrops, venous Doppler, heart size, heart function, and arterial Doppler, has been studied as it relates to prognosis in fetuses with hydrops, CHD, and growth restriction.…”

Section: Cardiac Function Assessmentmentioning

confidence: 99%

Diagnosis and Treatment of Fetal Cardiac Disease

Donofrio¹,

Moon-Grady²,

Hornberger³

et al. 2014

Circulation

Self Cite

1,020

543

View full text Add to dashboard Cite

Background— The goal of this statement is to review available literature and to put forth a scientific statement on the current practice of fetal cardiac medicine, including the diagnosis and management of fetal cardiovascular disease. Methods and Results— A writing group appointed by the American Heart Association reviewed the available literature pertaining to topics relevant to fetal cardiac medicine, including the diagnosis of congenital heart disease and arrhythmias, assessment of cardiac function and the cardiovascular system, and available treatment options. The American College of Cardiology/American Heart Association classification of recommendations and level of evidence for practice guidelines were applied to the current practice of fetal cardiac medicine. Recommendations relating to the specifics of fetal diagnosis, including the timing of referral for study, indications for referral, and experience suggested for performance and interpretation of studies, are presented. The components of a fetal echocardiogram are described in detail, including descriptions of the assessment of cardiac anatomy, cardiac function, and rhythm. Complementary modalities for fetal cardiac assessment are reviewed, including the use of advanced ultrasound techniques, fetal magnetic resonance imaging, and fetal magnetocardiography and electrocardiography for rhythm assessment. Models for parental counseling and a discussion of parental stress and depression assessments are reviewed. Available fetal therapies, including medical management for arrhythmias or heart failure and closed or open intervention for diseases affecting the cardiovascular system such as twin–twin transfusion syndrome, lung masses, and vascular tumors, are highlighted. Catheter-based intervention strategies to prevent the progression of disease in utero are also discussed. Recommendations for delivery planning strategies for fetuses with congenital heart disease including models based on classification of disease severity and delivery room treatment will be highlighted. Outcome assessment is reviewed to show the benefit of prenatal diagnosis and management as they affect outcome for babies with congenital heart disease. Conclusions— Fetal cardiac medicine has evolved considerably over the past 2 decades, predominantly in response to advances in imaging technology and innovations in therapies. The diagnosis of cardiac disease in the fetus is mostly made with ultrasound; however, new technologies, including 3- and 4-dimensional echocardiography, magnetic resonance imaging, and fetal electrocardiography and magnetocardiography, are available. Medical and interventional treatments for select diseases and strategies for delivery room care enable stabilization of high-risk fetuses and contribute to improved outcomes. This statement highlights what is currently known and recommended on the basis of evidence and experience in the rapidly advancing and highly specialized field of fetal cardiac care.

show abstract

“…A tool for the assessment of cardiac function is the cardiovascular profile score that combines ultrasonic markers of fetal cardiovascular Advances in fetal cardiology Comparetto and Borruto 11 unwellness on the basis of univariate parameters, which have been correlated with perinatal mortality. This 'heart failure score' could potentially be used in much the same way as and in combination with the biophysical profile score, as we have seen before [101].…”

Section: Prenatal Diagnosis and Screening Of Fetal Cardiac Abnormalitiesmentioning

confidence: 94%

Advances in fetal cardiology

Comparetto

Borruto

2014

Evidence Based Womenʼs Health Journal

View full text Add to dashboard Cite

The prevalence of congenital heart malformations as a whole (including diseases of little clinical significance) is 0.8% (8 of 1000 live births). The most frequent pathologies are malformations that prevent blood from reaching the lungs to take oxygen or block the normal supply of oxygenated blood to the body. The transposition of the great vessels (the aorta and pulmonary artery originate from the 'wrong' ventricles) is important as it represents the most severe neonatal heart disease. A separate issue, instead, is that of arrhythmias. The diagnosis is made around the 20th-21st week of gestation through a targeted ultrasound examination of fetal heart. This enables the recognition of the vast majority (around 85%) of clinically important congenital heart diseases (CHD) at birth. Nevertheless, targeted examinations are not possible for all pregnancies: the costs would not allow it. They are still available for patients who have recognized risk factors (they had children with previous CHD, they took teratogenic drugs, or they have diabetes), whereas pregnant women who have a very low risk are subjected to basic ultrasound examinations. An ultrasound examination allows at least suspicion of a significant proportion (30-40%) of important heart diseases. Progresses in the diagnostic field are continuous and the development of visualization techniques provides great opportunities. Four-dimensional (4-D) ultrasound that allows volumetrical viewing of the fetus, moving, to the most detailed facial expressions, appears to be promising in the diagnosis of CHD, which often escape the traditional ultrasound examination. Enabling better visualization of the heart, thanks to the ability to view it from different points and angles, volumetric ultrasound could aid the diagnosis of more heart diseases. Recognition of fetuses with heart disease may be useful for planning targeted interventions. The purpose of prenatal diagnosis is, first, to improve the prognosis without serious damages in the neonatal period. If necessary, there is the possibility of interventions on the fetus (which mainly consists of aortic or pulmonary valve and foramen ovale dilation), but they are still experimental cardiac procedures. In general, the first interventions take place on the newborn baby; therefore, the birth can be arranged at a cardiology and cardiac surgery unit, thus avoiding delays and dangerous transfers. Thanks to the timely diagnosis, today, 90% of operated babies survive and reach adulthood with a normal life expectancy (only for patients with univentricular heart, we impose limits on physical and working activity). Today, complex operations are possible even in low-birth-weight babies, with very good results, attempting to prioritize corrective radical rather than palliative solutions, which until recently were often the only options. As medical therapies play a marginal role in heart malformations, they are instead essential in the treatment of fetal tachyarrhythmias: these are quite rare diseases, which are also detectable by echoc...

show abstract

Doppler in Fetal Heart Failure

Cited by 42 publications

References 29 publications

The Study of Fetal Rat Model of Intra-Amniotic Isoproterenol Injection Induced Heart Dysfunction and Phenotypic Switch of Contractile Proteins

The Study of Fetal Rat Model of Intra-Amniotic Isoproterenol Injection Induced Heart Dysfunction and Phenotypic Switch of Contractile Proteins

Diagnosis and Treatment of Fetal Cardiac Disease

Advances in fetal cardiology

Contact Info

Product

Resources

About