Gestational age- and estimated fetal weight-adjusted reference ranges for myocardial tissue Doppler indices at 24-41 weeks' gestation

Abstract

Objectives To construct gestational age (GA)- and estimated fetal weight (EFW)-adjusted reference ranges for tissue Doppler cardiac function parameters from 24 to 41 weeks' gestation. Methods This was a prospective cross-sectional observational study involving 213 singleton pregnancies between 24 and 41 weeks' gestation. Myocardial peak velocities and myocardial performance index (MPIâ) were measured by tissue Doppler ultrasonography (values indicated by 'prime') in the left and right annulus and interventricular septum. Left and right atrioventricular parameters were also measured by conventional Doppler and ratios between the values found by the two methods calculated. Regression analysis was used to determine GA- and EFW-adjusted reference ranges and to construct nomograms for tissue Doppler parameters. Results All myocardial peak velocities, left and right Eâ/Aâ and left MPIâ showed a progressive increase with GA. In contrast, left and right E/Eâ showed a progressive decline. Septal Eâ/Aâ, and right and septal MPIâ remained constant. Myocardial peak velocities showed a progressive increase with increasing fetal weight. Conclusions Normal data of fetal myocardial peak velocities, their ratios and MPIâ by tissue Doppler adjusted by GA and EFW are provided. The reported reference values may be useful in research or clinical studies and can be used in fetuses with intrauterine growth restriction. Copyright © 2011 ISUOG. Published by John Wiley & Sons, Ltd. Copyright © 2011 ISUOG. Published by John Wiley & Sons, Ltd.