Myocardial Tissue Doppler Research Articles

Adrenal gland dysfunction and myocardial Tissue Doppler echocardiographic abnormalities in Patients with Beta Thalassemia Major: cross sectional study

Background: Adrenal, parathyroid gland and myocardial echocardiographic abnormalities are recognized with variable outcomes in patients with transfusion dependent Beta-Thalassemia major (-TM). Aim: In this cross-sectional analytic study in patients with -TM, we evaluate the left ventricle systolic and diastolic function using Pulsed Doppler (PD) and Tissue Doppler (DT) echocardiogram with simultaneous measurement of serum level of cortisol and parathyroid hormone. Methods: The study was conducted on patients with ?-TM (n = 99, age 15.928.92 years) and compared with an age-matched controls (n = 98 age 15.798.94 years). In all participants echocardiographic indices of M mode and PD and TD were performed. Blood samples were withdrawn for measuring the serum cortisol, parathyroid and Ferritin. Correlation between the level of cortisol and ferritin level was evaluated. Results: Patients with ?-TM compared with controls, have significantly thicker LV septal wall index of 0.65 0.26 vs. 0.44 0.2190, P<0.001 and LV posterior wall of 0.65 0.235 vs. 0.43 0.214, P< 0.001, with no significant dilation of LV cavity in systole and diastole. The systolic function of LVFE% was normal of 51.95?5.5 vs. 5.0?5.6, p=0.23. Furthermore patients with ?-TM have higher E/A ratio (1.540.18 vs. 1.230.17, P<0.01) and shorter deceleration time (DT) (170.5313.3 vs. 210.5019.20 m sec, P<0.01). The ratio of transmitral E wave velocity to the tissue Doppler E wave at the basal septal mitral annulus (E/Em) was significantly higher in ?-TM group (19.682.81 vs. 13.861.41, P<0.05). The tissue Doppler systolic wave (Sm) velocity and the early diastolic wave (Em) were significantly lower in ?-TM group compared with controls with Sm, of 4.821.2 vs. 6.222.1 cm/sec, P<0.05 and (Em) of 3.512.7 vs. 4.122.5 cm/sec P<0.05, respectively). The tricuspid valve velocity was significantly higher in ?-TM patients compared with controls (2.850.56 vs. 1.7430.47 m/sec, respectively, P<0.01). The prevalence of adrenal insufficiency in patients with -TM was 16 %, hypoparathyroidism of 4.5%. There was a weak negative correlation between serum level of cortisol and the serum Ferritin. Conclusion: Patients with ?-thalassemia major had a high prevalence of subclinical adrenal insufficiency of 16%, hypoparathyroidism of 4.5% with weak negative correlation between the low level of cortisol ?160 nmol/L and high serum ferritin. Echocardiographic Pulsed Doppler showed a restrictive LV diastolic pattern suggestive of advanced diastolic dysfunction but preserved left ventricle systolic function.

Myocardial Velocities, Dynamics of the Septum Primum, and Placental Dysfunction in Fetuses with Growth Restriction

Diastolic dysfunction may occur in fetuses with intrauterine growth restriction (IUGR) and may be assessed by myocardial tissue Doppler (MTD). We previously have shown that excursion index of the septum primum (EISP) is reduced in IUGR fetuses over 30 weeks because of a higher left atrial pressure. The sample was made up of 14 fetuses with IUGR. MTD examination was carried out with the sample volume placed at the basal lateral wall of the left ventricle (LV), interventricular septum (IVS), and free wall of the right ventricle (RV) to determine E'/A' ratios. EISP was calculated as the ratio between the maximal excursion of the septum primum into the left atrium during diastole and the maximal diastolic diameter of the left atrium. Mitral and tricuspid flows were assessed by the conventional Doppler method. Pearson's correlation test was used to analyze the correlations between the parameters. A positive correlation was observed between UARI and E'/A' ratios for RV (r = 0.63, P = .02), IVS (r = 0.59, P = .03), and LV (r = 0.41, P = .15). There was a negative correlation between EISP and IVS E'/A' ratios (r = -0.58, P = .03), and a positive correlation for LV (r = 0.49, P = .08). At the RV position, a weak negative correlation was observed (r = -0.32, P = .26). A higher left atrial pressure in fetuses with IUGR, indicated by the lower mobility of the septum primum, is accompanied by higher ratios between early and late diastolic myocardial velocities. Placental dysfunction was correlated to septal E'/A' ratios. Fetal MTD can be a useful method to assess severity of placental dysfunction and fetal distress.

Serial change in myocardial tissue Doppler imaging from fetus to neonate

BackgroundOur goal was to evaluate the serial change in myocardial performance from fetus to neonate using tissue Doppler imaging (TDI). Method and resultsThere were 37 term infants in the present study. The TDI sensor was placed at the level of the lateral mitral annulus (M-TDI), inter-ventricular septum (IVS-TDI) and the lateral tricuspid annulus (T-TDI). We measured TDI parameters from fetus to neonate. On univariate analysis, E′ (cm/s), A′ (cm/s), and S′ (cm/s) of three ventricular walls of TDI parameters excluding E′ IVS-TDI significantly decreased during the transition from fetal to neonatal circulation. E′/A′ ratio, E/E′ ratio and myocardial performance index (MPI) of three ventricular walls of TDI parameters excluding T-TDI MPI significantly increased during the transition from fetal to neonatal circulation. When multiple linear regression analysis with a step-wise procedure during the transition from fetus to neonate for TDI parameters was applied to variables, significant differences were noted for predicting decreases in M-TDI S′ (6.55 to 3.97, p<0.001) and IVS-TDI A′, (6.69 to 4.69, p<0.001), and increases in IVS-TDI E′/A′ ratio (0.77 to 1.02, p<0.001) and IVS-TDI E/E′ ratio (8.25 to 13.65, p<0.001). ConclusionIn conclusion, we found that the myocardial performances of both ventricles decreased during the transition from fetus to neonate using TDI parameters. In particular, left ventricular systolic performance was affected more than when fetal circulation changed to neonate circulation. Our findings suggest that serial change in TDI can give new information to estimate myocardial performance of the neonate.

Right Ventricular Mechanics in the Fetus with Hypoplastic Left Heart Syndrome

Right ventricular mechanics influence outcomes in patients with hypoplastic left heart syndrome (HLHS). The aim of this study was to determine whether differences in right ventricular performance have their origins in fetal life and if the architectural character of the hypoplastic left ventricle affects right ventricular mechanics. The first complete fetal echocardiograms after 17 weeks' gestation were reviewed in 84 fetuses withHLHS and in 115 gestational age-matched normal controls. Inflow, outflow, and myocardial tissue Dopplervelocities were measured. E/A and E/e' ratios and right ventricular myocardial performance index were calculated. In fetuses with HLHS, there were lower tricuspid E/A ratios (mean, 0.6 ± 0.1 vs 0.7 ± 0.1; P < .001), higher E/e' ratios (mean, 8.1 ± 2.6 vs 7.0 ± 1.3; P= .006), and higher right ventricular myocardial performance indices (mean, 0.47 ± 0.14 vs 0.40 ± 0.10; P < .001) compared with controls. Among fetuses with HLHS grouped according to left ventricular architecture, those with left ventricular endocardial fibroelastosis had the most striking differences in right ventricular mechanics. Right ventricular mechanics are different from normal in fetuses with HLHS and are influenced by the presence of left ventricular endocardial fibroelastosis. These differences precede the imposition of undue loading conditions as a consequence of surgical palliation and may offer clues to the development of later right ventricular failure.

Authors’ Response: possible contribution of fetal size and gestational age to myocardial tissue Doppler velocities in preterm fetuses

Authors’ Response: possible contribution of fetal size and gestational age to myocardial tissue Doppler velocities in preterm fetuses

Functional Maturation of Left and Right Atrial Systolic and Diastolic Performance in Infants, Children, and Adolescents

Left atrial (LA) function is an important modulator of left ventricular filling and has a prognostic role in adult heart failure, but pediatric data are limited. The aim of this study was to characterize the normal LA and right atrial (RA) strain (ε) and strain rate (SR) in infants and children. Atrial ε and SR were prospectively investigated in 153 subjects using two-dimensional speckle-tracking echocardiography. High-frame rate, three-beat captures of LA (15-segment model; two-chamber, three-chamber, and four-chamber views) and RA (six-segment model; four-chamber view) were analyzed (Vivid 7, EchoPAC BT11). LA and RA segmental and global peak positive ε (εPos) and negative ε (εNeg) and peak positive SR, early negative SR, and late negative SR were measured. Linear and nonlinear regressions of ε and SR were performed with age and heart rate. Relationships of ε and SR with ventricular inflow Doppler and myocardial tissue Doppler indices were explored. The age range was 3 days to 20 years, and body surface area range from 0.17 to 2.3 m(2) for the study cohort. Mean global LA εPos, LA εNeg, RA εPos, and RA εNeg were 28 ± 9%, -16 ± 6%, 23 ± 9%, and -15 ± 6%, respectively. Positive correlations were found for global atrial εPos and εNeg with age (P < .001). A marked rate of changes in ε and SR was seen in the first year of life, reaching normal adult values by adolescence. Peak positive SR had a strong negative correlation with age, and early negative SR had a strong positive correlation with age (P < .001), while late negative SR was correlated nonlinearly. Heart rate and age both influenced all LA and RA ε and SR indices. Maturational changes in LA and RA ε and SR occur in normal children and are especially profound in infancy. Consequently, LA and RA performance indices must be interpreted in light of heart rate and age. Normal values and percentiles for atrial ε and SR reported here will provide a foundation for the study of pediatric atrial physiology and function in disease states.

Organised right ventricular remodelling in aortic stenosis even after valve replacement

Organised right ventricular remodelling in aortic stenosis even after valve replacement

EFFECT OF IRON AND SELENIUM DRUGS ON DIASTOLIC MYOCARDIAL FUNCTION IN PATIENTS WITH ANEMIC CARDIOMYOPATHY

Aim. To study the changes of the left (LV) and right (RV) ventricles diastolic function, the segmental LV diastolic function in patients with anemic cardiomyopathy after the iron and selenium drugs therapy. Material and methods. Patients (n=54) with severe chronic post-hemorrhagic iron deficiency anemia, complicated by cardiomyopathy were treated with iron sulfate and sele- nium. Segmental LV diastolic function was evaluated with pulsed tissue Doppler, and global diastolic function of the LV and RV – with Doppler echocardiography, before and af- ter treatment. Control group contained 16 healthy individuals Results. Disorders of segmental LV diastolic function, and both ventricles global diastolic function were found in anemic patients with cardiomyopathy. Flow rate rapid filling re- duced by 27.1% compared with this in control (p<0.001), and flow rate of atrial filling increased by 27.0% (p<0.001), and E/A decreased by 42.2% (p<0.001). Iron and se- lenium therapy in patients with anemic cardiomyopathy led to an improvement in diastolic function. LV and RV flow rapid filling increased by 32.2% (p<0.001) and 8.3% (p<0.05), respectively, and LV and RV flow rate of atrial filling reduced by 19.6% and 15.7% (p<0.001), respectively, and LV and RV E/A ratio grew up by 61.5% and 28.2%, respective- ly (p<0.001). Conclusion. Echocardiography and myocardial tissue Doppler provide early finding of segmental LV diastolic function disorders in anemic cardiomyopathy. Iron and selenium ther- apy leads to improvement of myocardial diastolic function in these patients.

REMODELING OF THE RIGHT HEART AND THE LEVEL OF BRAIN NATRIURETIC PEPTIDE IN PATIENTS WITH CHRONIC THROMBOEMBOLIC PULMONARY HYPERTENSION: A COMPARATIVE CROSS-SECTIONAL OBSERVATIONAL STUDY

Aim. To study the right heart remodeling and level of N-terminal brain natriuretic peptide (Nt-proBNP) in patients with chronic thromboembolic pulmonary hypertension (CTEPH). Material and methods. Patients (n=79) after pulmonary embolism were included into the study. The main group consisted of patients (n=43) with an increase in systolic pulmonary artery pressure (SPAP) &gt;30 mm Hg: 30 (37.9%) patients had pulmonary hypertension (PH) degree I, and 13 (16.5%) — PH degree II–III. Group of comparison con- sisted of 36 patients expired pulmonary embolism and having SPAP &lt;30 mm Hg. The control group consisted of 20 people. 6-minute walk test (6-MWT) and Doppler echocardiography were performed in all patients. Besides myocardial tissue Doppler echocardiography and assessment of Nt-proBNP level were performed in 38 and 71 patients, respectively. Results. Dyspnea occurred in 90.7% of patients with various degrees of PH and 80.5% of patients with normal SPAP. Patients without PH and with PH I complained of palpitations, weakness, fatigue, and dizziness with similar frequency. Patients with PH I were comparable with ones of comparison group in 6-MWT distance that dramatically decreased in patients with PH II–III. Enlargement of the right atrium (RA) and/or right ventricular (RV) was observed in 76.7% of patients with PH I and 100% of patients with PH II–III. RV diastolic function abnormalities (E/A&lt;1 and E/A&gt;2) were detected in 19.4%, 16.7% and 61.5% of patients of comparison group, PH I and PH II–III patients, respectively. According to myocardial tissue Doppler echocardiography Em/Am&lt;1 was observed in 8 (72.7%) patients of the comparison group and in 13 (76.4%) patients with PH. Nt-proB-NP level was 17.3 [2.3, 33.9] fmol/ml in PH I patients and 142.1 [62.1, 171.8] fmol/ml in PH II–III patients. Nt-proBNP level was 6.5 [3.1, 18.3] fmol/mL in patients of the comparison group, and it was higher than this in patients of the control group (3.5 [1.8, 7.5 fmol/ml]. Conclusion. Various indicators of heart remodeling and RV diastolic dysfunction were found in the majority of patients after pulmonary embolism, including those with nor- mal SPAP. Elevation of Nt-proBNP level adequately reflects the severity of RV dysfunction in CTEPH patients only in PH II–III. This marker has low diagnostic value in patients with- out CTEPH and PH I patients.

Recent advances in pediatric echocardiography

Echocardiography is the fundamental tool in the management of children with congenital heart disease (CHD), and cross-sectional echocardiography is still the main technique used for diagnosis and therapeutic planning. Recent advances in pediatric echocardiography include 3D echocardiography and functional imaging. The recent development of specific pediatric probes allows imaging of pediatric hearts with high temporal and spatial resolution. Lesions are often anatomically complex, and 3D echocardiography allows increased appreciation of complex spatial relationships and can thereby be valuable in understanding functional anatomy and planning interventions. Assessment of pediatric myocardial function can be difficult, with highly variable ventricular morphology. Assessment of right ventricular function and function of the single ventricle are current challenges in CHD. The introduction of myocardial tissue Doppler velocities and deformation imaging (strain and strain-rate quantification) facilitates the quantification of myocardial function independent of underlying morphology. These techniques offer new insights into the mechanics of CHD.

DOPPLER TISSUE IMAGING: PRINCIPLES AND POSSIBILITIES OF THE METHOD (literature review)

Doppler tissue imaging is a group of regimes based on the Doppler effect and the qualitative and quantitative assessment of the global and segmental myocardial function. Doppler tissue imaging enables to evaluate quantitatively the functional state of not only the left, but also the right ventricle. The using of Doppler tissue imaging is informative for assessing the global and regional function of the left heart ventricle. The Doppler tissue imaging made it possible to assess the systolic and diastolic function of the various segments of the left and right ventricles. The review presents the information about the principles and possibilities of Doppler tissue imaging, the new technology of ultrasound heart examination in assessment of myocardial function. The review also covers the history of myocardial Doppler tissue imaging. The main attention is focused on the characterization of Doppler myocardial tissue imaging regimes.

Possible contribution of fetal size and gestational age to myocardial tissue Doppler velocities in preterm fetuses

Possible contribution of fetal size and gestational age to myocardial tissue Doppler velocities in preterm fetuses

599 Cardiovascular Consequences of Bronchopulmonary Dysplasia in Prematurely Born Preschool Children

Backgroud and aims:Bronchopulmonary dysplasia (BPD) is one of the most important chronic complications of premature birth. Although long term effects of BPD are more commonly known by the well-defined pulmonary...

Right Ventricular Dysfunction after Coronary Artery Bypass Grafting Is a Reality of Unknown Cause and Significance

To evaluate the impact of coronary bypass surgery on the function of the right ventricle (RV) in patients with a pre-operative ejection fraction ≥ 35% who did not have any perioperative myocardial infarction. We performed a prospective study of 30 patients who underwent uneventful isolated coronary artery bypass grafting (CABG). All patients had echocardiography prior to surgery and 3 months postoperatively. Myocardial tissue Doppler velocities were used to measure left and right ventricular function. The right ventricular myocardial performance index (Tei) and the ratio between the velocities of the RV and left ventricle (LV) were also calculated. There was a significant improvement in left ventricular ejection fraction before and after CABG (P = .046). The tissue Doppler imaging (TDI) velocities from the LV remained unchanged, but highly significant reductions in right ventricular TDI velocities were observed (P <.001). The TDI peak systolic (S), early diastolic (E), and late diastolic (A) velocities had a reduction of 30%, 34.5%, and 20%, respectively. Similarly, a fall in RV to LV ratios of various TDI velocities was also observed. This was also accompanied by a significant rise in the RV Tei index. All of these findings are suggestive of significant RV dysfunction. There is a marked impairment of RV function after CABG.

Abstract 125: Cardiac Myosin Binding Protein-C Phosphorylation Is Critical for Normal Diastolic Function

Heart failure with preserved ejection fraction (HFpEF) accounts for approximately 50% of all cases of heart failure, but there is no effective treatment of this disease. Cardiac myosin binding protein-C (MyBPC3) is a thick filament protein that is thought to slow cross-bridge cycling by inhibiting acto-myosin interaction. When phosphorylated, MyBPC3 releases its inhibition thereby accelerating cross-bridge cycling. Thus, we hypothesize that MyBPC3 phosphorylation enhances heart’s ability to relax (lusitropy). To test this idea, we expressed wild type MyBPC3(tWT), non-phosphorylatable MyBPC3(t3SA), and constitutively phosphorylated mimetic MyBPC3(t3SD) onto MyBPC3(-/-) mouse background. We used echocardiography, voluntary running, and measurements of brain natriuretic peptide (BNP) for comparison. MyBPC3(t3SA) and MyBPC3(t3SD) hearts had similar ejection fraction as MyBPC3(tWT) hearts. MyBPC3(t3SA) hearts show depressed diastolic function revealed by slower myocardial tissue Doppler relaxation velocity at the mitral valve annulus (Ea) and an increased mitral blood flow/myocardium relaxation ratio (E/Ea). In contrast, MyBPC3(t3SD) hearts exhibited enhanced lusitropy with increased Ea and smaller E/Ea. Moreover, the findings of shorter 7-day average voluntary running distances, increased lung/body weight ratios, and increased BNP levels indicated heart failure in MyBPC3(t3SA) mice. Conversely, MyBPC3(t3SD) mice did not show signs of heart failure. Since cardiac function in MyBPC3(t3SA) mice resembles HFpEF and MyBPC3(t3SD) mice exhibit enhanced lusitropy, we conclude that phosphorylation of MyBPC3 is crucial for normal diastolic function.

Subendocardial dysfunction in patients with chronic severe aortic regurgitation and preserved ejection fraction detected with speckle-tracking strain imaging and transmural myocardial strain profile

It remains difficult to detect subtle left ventricular (LV) myocardial dysfunction in chronic aortic regurgitation (AR) patients with the preserved ejection fraction (EF). We studied 36 chronic severe AR patients undergoing surgical correction with the EF of 58 ± 6% (all ≥ 50%). Echocardiography was performed before and 12 ± 8 months after surgical correction. We used two-dimensional speckle-tracking strain imaging to evaluate global radial strain in the inner-half (GRSinner), outer-half (GRSouter), and total (GRStotal) layer from the mid-LV short-axis view. We also evaluated the transmural strain profile in the LV posterior wall by using myocardial tissue Doppler radial strain, and the location of peak strain was determined as the percentage of the distance from the endocardium to the epicardium accounted for by the wall thickness. Fifteen EF-matched normal volunteers were studied for comparison. GRSinner for AR patients was significantly smaller than that for controls (28.9 ± 12.9 vs. 37.1 ± 9.1%, P = 0.032), and the location of peak strain had significantly shifted to the epicardial side compared with that in controls (27.1 ± 14.0-13.2 ± 4.8%, P = 0.001). In contrast, GRStotal and GRSouter were similar for the two groups. After surgical correction, EF increased from 58 ± 6 to 62 ± 7% (P = 0.018), GRSinner from 27.8 ± 12.5 to 37.7 ± 14.6% (P < 0.0001), and the location of peak strain significantly shifted to the endocardial side (26.9 ± 13.9-19.1 ± 11.9%, P = 0.028). However, GRStotal and GRSouter did not change. The LV endocardium side, impaired in chronic AR patients with the preserved EF, improved after surgical correction. Our observations may prove useful for evaluating subtle early changes in such patients.

Moxonidine-based combination antihypertensive therapy in patients with metabolic syndrome

Aim.To assess the effects of moxonidine-based combination therapy on clinical status, laboratory parameters, and target organs in patients with metabolic syndrome (MS).Material and methods.In total, 60 MS patients with Stage 1-2 arterial hypertension (AH) were randomised into 3 groups. Group I was administered moxonidine (0,2-0,4 mg/d) and amlodipine (5-10 mg/d); Group II received moxonidine (0,2-0,4 mg/d) and hydrochlorothiazide (12,5 mg/d); Group III was treated with moxonidine (0,2-0,4 mg/d) and enalapril (10-20 mg/d). At baseline and after 24 weeks of treatment, the following characteristics were assessed: waist circumference (WC), body mass index (BMI), 24-hour blood pressure monitoring (BMP) parameters, left ventricular myocardial mass index (LVMMI), E/A ratio, isovolumetric relaxation time (IVRT), deceleration time (DT) of early diastolic velocity, peak Em velocity at interventricular septum and lateral wall levels, E/Em ratio (myocardial tissue Doppler echocardiography), pulse wave velocity (PWV) between descending aorta and aortic bifurcation levels (ultrasound method), and stiffness index β of ascending aorta. In addition, lipid, carbohydrate, and purine metabolism parameters were assessed; glomerular filtration rate (GFR) was calculated (MDRD method); and urine albumin levels were measured.Results.In Group I (moxonidine + amlodipine), target blood pressure (BP) levels were achieved in 70% of the patients. Systolic BP (SBP) levels, LVMMI, and DT decreased by 19,3±11,4 mm Hg, 4,4 g/m2 (p=0,09), and 10,6 ms (p&lt;0,05), respectively. The increase in E/A ratio and Em annular velocity (Em av) reached 0,4 (p&lt;0,05) and 1,4 cm/s (p&lt;0,05), respectively, while E/Em av ratio decreased by 0,8 (p&lt;0,05), and PWV decreased by 1,6 ms (p&lt;0,05). The BMI decrease reached 0,7 kg/m2 (p&lt;0,05). In Group II (moxonidine + hydrochlorothiazide), target BP levels were achieved in 40% of the participants, with a decrease in SBP levels by 14,7 mm Hg (p&lt;0,05). DT was reduced by 9,4 ms (p&lt;0,05), E/A ratio increased by 0,1 (p&lt;0,05), while PWV, BMI, and GFR decreased by 1,3 m/s (p&lt;0,05), 0,8 kg/m2 (p&lt;0,05), and 5,6 ml/min/1,73 m2 (p&lt;0,05), respectively. In Group III (moxonidine + enalapril), 60% of the patients achieved target BP levels, and SBP levels were reduced by 21,1 mm Hg (p&lt;0,05). LVMMI decreased by 5,1 g/m2 (p&lt;0,05), Em av increased by 0,3 cm/s (p&lt;0,05), while the respective reduction in PWV, WC, and BMI reached 1,1 m/s (p&lt;0,05), 1,8 cm (p&lt;0,05), and 0,5 kg/m2 (p&lt;0,05). All three groups demonstrated a significant reduction in urine albumin levels.Conclusion.The moxonidine-based combination therapy effectively reduced the levels of BP and urine albumin. The combination of moxonidine with amlodipine or enalapril improved cardiac structure and function, as well as renal excretory function. The combination of moxonidine and hydrochlorothiazide, however, negatively affected renal excretion. All three variants of combination therapy were metabolically neutral and demonstrated beneficial effects on visceral obesity.

Quantitative evaluation of cardiac morphology and function of fetuses in pregnancies complicated by gestational impaired glucose tolerance using fetal echocardiography

Objective To quantitative evaluate the alterations of cardiac morphology and function in gestational impaired glucose tolerance(GIGT) fetuses.Methods Fetal echocardiograms were performed on 68 GIGT fetuses with gestation age between 21 ～ 40 weeks for evaluation of cardiac morphology and function.Fetal cardiac morphology,systolic and diastolic functions of 68 GIGT fetuses were compared with 81 control group fetuses using conventional two-dimensional,M-mode,pulsed Doppler echocardiography and myocardial tissue Doppler imaging.Results Comprehensive fetal echocardiography data analysis showed no significant differences in cardiac morphology and function between two groups (P＞0.05).Conclusions The alterations of cardiac morphology and function in GIGT fetuses can be accurately and objectively evaluated using quantitative evaluation in fetal echocardiography and will help to offer consultation. Key words: Ultrasonography,prenatal; Fetus; Gestational impaired glucose tolerance; Ventricular function

Deterioration of myocardial tissue Doppler indices in a case of fetal hydrothorax as a promising indication for clinical intervention before the development of nonimmune hydrops fetalis

Deterioration of myocardial tissue Doppler indices in a case of fetal hydrothorax as a promising indication for clinical intervention before the development of nonimmune hydrops fetalis

073 Evaluation of clinical markers of early disease expression and the ability to predict genotype in families with HCM and mutations in cardiac myosin binding protein C

IntroductionFamilial evaluation for the presence of left ventricular hypertrophy (LVH) is an important part of management in hypertrophic cardiomyopathy. However due to incomplete penetrance, the presence of LVH does not...