Endocardial Fibroelastosis of the Left Ventricle Affects Right Ventricular Performance in Fetuses with Hypoplastic Left Heart Syndrome: A Prospective Study Using M-Mode, PW- and Tissue Doppler Techniques.

Graupner, Oliver; Enzensberger, Christian; Wieg, Larissa; Degenhardt, Jan; Wolter, Aline; Khalil, Markus; Schranz, Dietmar; Yerebakan, Can; Doelle, Astrid; Herrmann, Johannes; Axt-Fliedner, Roland

doi:10.1055/s-0043-111590

journal article

Document type:: journal article
Author(s):: Graupner, Oliver; Enzensberger, Christian; Wieg, Larissa; Degenhardt, Jan; Wolter, Aline; Khalil, Markus; Schranz, Dietmar; Yerebakan, Can; Doelle, Astrid; Herrmann, Johannes; Axt-Fliedner, Roland
Title:: Endocardial Fibroelastosis of the Left Ventricle Affects Right Ventricular Performance in Fetuses with Hypoplastic Left Heart Syndrome: A Prospective Study Using M-Mode, PW- and Tissue Doppler Techniques.
Abstract:: Myocardial function (MF) of the systemic right ventricle (RV) influences the postnatal course of neonates with hypoplastic left heart syndrome (HLHS). Our study examines whether the presence of endocardial fibroelastosis of the left ventricle (LV EFE) influences MF of the RV in HLHS fetuses. A prospective study was conducted including 10 controls (group 1), 10 HLHS fetuses with (group 2) and 10 without LV EFE (group 3) - all matched for gestational age. M-mode was used to assess tricuspid plane systolic excursion (TAPSE) and the shortening fraction (SF). PW-Doppler-derived and PW-TDI-derived velocities were assessed. E/A, E/e', e'/a' ratios and the myocardial performance index (mpi') were calculated. The examination of MF revealed significantly lower s' velocities (p< 0.05) and higher values for SF in group 2 compared to group 3. e'/a' ratio, et' (ejection time), E wave velocity, E/e' and SF showed significantly higher values in group 2 compared to group 1. In group 2 a' velocity increased significantly over gestational age. In group 3 but not in group 2, TAPSE increased during gestation. These significant differences in MF between the groups might lend support to the notion of negative ventricular-ventricular interaction in the case of HLHS with LV EFE possibly influencing surgical outcomes.
Journal title abbreviation:: Ultraschall Med
Year:: 2017
Language:: eng
Fulltext / DOI:: doi:10.1055/s-0043-111590
Pubmed ID:: http://view.ncbi.nlm.nih.gov/pubmed/28683514
Print-ISSN:: 0172-4614
TUM Institution:: Klinik und Poliklinik für Frauenheilkunde
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mediaTUM Gesamtbestand Einrichtungen Schools TUM School of Medicine and Health Departments Clinical Medicine Klinik und Poliklinik für Frauenheilkunde (Prof. Kiechle)2017