The prevalence and clinical significance of fetal tricuspid valve regurgitation with normal heart anatomy

Respondek, M.; Kammermeier, Michael; Ludomirsky, A.; Weil, Sharon R.; Huhta, James C.

doi:10.1016/0002-9378(94)90144-9

Cited by 88 publications

(57 citation statements)

References 19 publications

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“…In normal pregnancies, the incidence of TR is Ϸ6% during the second half of gestation. 16 In the present study, the incidence of TR was higher, especially in fetuses with myocardial cell damage (54.5%). However, similar TR dP/dT between the groups suggest that the right ventricle is able to maintain its contractility despite increased afterload.…”

Section: Discussionsupporting

confidence: 44%

“…15 Tricuspid regurgitation was noted. 16 From the fetal venous circulation, pulsatility index values for veins (PIVϭ[peak systolic velocityϪvelocity during atrial contraction]/time-averaged maximum velocity over the cardiac cycle) for the ductus venosus (DV), left hepatic vein (LHV), and inferior vena cava (IVC) were calculated. 3 Atrial pulsations in the intra-abdominal umbilical vein were noted.…”

Section: Ultrasonographic Measurementsmentioning

confidence: 99%

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Ultrasonographic and Biochemical Markers of Human Fetal Cardiac Dysfunction in Placental Insufficiency

et al. 2002

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Background-Placental insufficiency may lead to fetal cardiovascular compromise. We sought to determine whether ultrasonographic parameters of fetal cardiovascular function correlate with umbilical arterial levels of biochemical markers of myocardial dysfunction and damage in placental insufficiency. Methods and Results-In 48 fetuses with placental insufficiency, umbilical artery blood was obtained at delivery for assessment of N-terminal peptide of proatrial natriuretic peptide (NT-proANP) and cardiac troponin-T (cTnT). Group 1 fetuses (nϭ12) had normal NT-proANP and cTnT serum concentrations. Group 2 fetuses (nϭ25) showed increased NT-proANP (Ͼ1145 pmol/L) and normal cTnT values. Group 3 fetuses (nϭ11) had increased NT-proANP and cTnT (Ͼ0.10 ng/mL) levels. The ultrasonographic parameters of fetal cardiovascular function were compared between the groups. Pulsatility indices for veins of the ductus venosus, left hepatic vein, and inferior vena cava correlated significantly with NT-proANP levels. In group 3, ductus venosus, left hepatic vein, and inferior vena cava pulsatility indices for veins were higher (PϽ0.01) than in groups 1 and 2. The proportion of left ventricular cardiac output of combined cardiac output was greater (PϽ0.05) and that of right ventricle was smaller (PϽ0.05) in group 3 than in group 2. In group 3, tricuspid regurgitation was noted most often (PϽ0.05), and right ventricular fractional shortening was less (PϽ0.01) than in group 2. Conclusions-Pulsatility in human fetal systemic veins correlated significantly with the cardiac secretion of ANP. Fetuses with myocardial damage demonstrate increased systemic venous pressure, a change in the distribution of cardiac output toward the left ventricle, and a rise in right ventricular afterload.

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Section: Discussionsupporting

confidence: 44%

Section: Ultrasonographic Measurementsmentioning

confidence: 99%

Ultrasonographic and Biochemical Markers of Human Fetal Cardiac Dysfunction in Placental Insufficiency

et al. 2002

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“…No relationship was identified between the frequency of ductal constriction and the presence, or severity, of TR either during or after surgery. 34 In summary, echocardiographic monitoring of the heart during fetal surgery demonstrates that important hemodynamic derangements are common. If not looked for, these findings are missed.…”

Section: Discussionmentioning

confidence: 99%

Acute Cardiovascular Effects of Fetal Surgery in the Human

et al. 2004

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Background-Prenatal surgery for congenital anomalies can prevent fetal demise or alter the course of organ development, resulting in a more favorable condition at birth. The indications for fetal surgery continue to expand, yet little is known about the acute sequelae of fetal surgery on the human cardiovascular system. Methods and Results-Echocardiography was used to evaluate the heart before, during, and early after fetal surgery for congenital anomalies, including repair of myelomeningocele (MMC, nϭ51), resection of intrathoracic masses (ITM, nϭ15), tracheal occlusion for congenital diaphragmatic hernia (CDH, nϭ13), and resection of sacrococcygeal teratoma (SCT, nϭ4). Fetuses with MMC all had normal cardiovascular systems entering into fetal surgery, whereas those with ITM, CDH, and SCT all exhibited secondary cardiovascular sequelae of the anomaly present. At fetal surgery, heart rate increased acutely, and combined cardiac output diminished at the time of fetal incision for all groups including those with MMC, which suggests diminished stroke volume. Ventricular dysfunction and valvular dysfunction were identified in all groups, as was acute constriction of the ductus arteriosus. Fetuses with ITM and SCT had the most significant changes at surgery. Conclusions-Acute cardiovascular changes take place during fetal surgery that are likely a consequence of the physiology of the anomaly and the general effects of surgical stress, tocolytic agents, and anesthesia. Echocardiographic monitoring during fetal surgery is an important adjunct in the management of these patients.

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“…Reports emerged on pulmonary arterial and venous flow, on measurements across the fetal shunts such as the ductus arteriosus and foramen ovale, and even on the coronary artery and venous systems 37,[41][42][43][44][45][46][47][48][49][50] . The quantification of tricuspid valve insufficiency was shown to reveal valuable information on etiology and prognosis [51][52][53][54] . The pathological conditions investigated are no longer confined to fetal heart defects but have expanded to include other fetal conditions involving the cardiovascular system.…”

Section: Spectral Dopplermentioning

confidence: 99%

Fetal echo cardiography: the state of the art of the state of the heart

Chaoui¹

2001

Ultrasound in Obstet & Gyne

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The prevalence and clinical significance of fetal tricuspid valve regurgitation with normal heart anatomy

Cited by 88 publications

References 19 publications

Ultrasonographic and Biochemical Markers of Human Fetal Cardiac Dysfunction in Placental Insufficiency

Ultrasonographic and Biochemical Markers of Human Fetal Cardiac Dysfunction in Placental Insufficiency

Acute Cardiovascular Effects of Fetal Surgery in the Human

Fetal echo cardiography: the state of the art of the state of the heart

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