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中华医学超声杂志(电子版) ›› 2023, Vol. 20 ›› Issue (10) : 1089 -1093. doi: 10.3877/cma.j.issn.1672-6448.2023.10.015

综述

胎儿超声心动图评估心肌做功指数的研究进展
李贞, 韩吉晶, 吴青青()   
  1. 100026 首都医科大学附属北京妇产医院(北京妇幼保健院)超声科
  • 收稿日期:2022-10-17 出版日期:2023-10-01
  • 通信作者: 吴青青

Advances in fetal echocardiographic assessment of myocardial performance index

Zhen Li, Jijing Han, Qingqing Wu()   

  • Received:2022-10-17 Published:2023-10-01
  • Corresponding author: Qingqing Wu
引用本文:

李贞, 韩吉晶, 吴青青. 胎儿超声心动图评估心肌做功指数的研究进展[J]. 中华医学超声杂志(电子版), 2023, 20(10): 1089-1093.

Zhen Li, Jijing Han, Qingqing Wu. Advances in fetal echocardiographic assessment of myocardial performance index[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2023, 20(10): 1089-1093.

心功能不全是各种心脏病发展到一定阶段出现的临床症候群。多数心功能不全患者的收缩功能障碍和舒张功能障碍并存。1995年,国外学者Tei等提出了可以综合评价心脏收缩和舒张功能的指标——心肌做功指数(myocardial performance index,MPI),又称Tei指数(Tei index,TI)。本文对MPI的临床应用研究进展进行综述。

图1 心肌做功指数(Tei指数)测量示意图(以左心心肌做功指数为例)(图片改编自参考文献[1]) 注:a为跨二尖瓣血流结束到开始的时间间隔;b为心室射血时间(ET);c为心电图R波峰值到跨二尖瓣血流开始的时间间隔;d为心电图R波峰值到射血结束的时间间隔;ICT为等容收缩时间;IRT为等容舒张时间;Inflow为流入道;Outflow为流出道;ECG为心电图
图2 组织多普勒成像测量左心和右心的心肌做功指数(MPI')。图a为右心室组织多普勒(MPI')获得的心肌组织多普勒速度和心肌性能指标,包括E'波(舒张早期瓣环峰值速度)、A'波(舒张晚期瓣环峰值速度)和S'波(收缩期瓣环峰值速度),MPI'=等容收缩时间(ICT')+等容舒张时间(IRT')/射血时间(ET');图b为左心室组织多普勒(MPI')测量图,二尖瓣环组织多普勒图像显示心肌峰值速度和性能指标的测量(图a引自参考文献[6],图b引自参考文献[7]) 注:PVA为心房收缩时心肌峰值速度;PVE为舒张早期心肌峰值速度;PVS为收缩期心肌峰值速度
1
Tei C, Ling LH, Hodge DO, et al. New index of combined systolic and diastolic myocardial performance: a simple and reproducible measure of cardiac function-a study in normals and dilated cardiomyopathy[J]. J Cardiol, 1995, 26(6): 357-366
2
Hernandez-Andrade E, López-Tenorio J, Figueroa-Diesel H, et al. A modified myocardial performance (Tei) index based on the use of valve clicks improves reproducibility of fetal left cardiac function assessment[J]. Ultrasound Obstet Gynecol, 2005, 26(3): 227-232.
3
Mahajan A, Henry A, Meriki N, et al. The (pulsed-wave) Doppler fetal myocardial performance index: technical challenges, clinical applications and future research [J]. Fetal Diagn Ther, 2015, 38(1): 1-13.
4
Lee MY, Won HS, Shim JY, et al. Novel technique for measurement of fetal right myocardial performance index using dual gate pulsed-wave Doppler [J]. J Ultrasound Med, 2017, 36(8): 1585-1594.
5
Luewan S, Tongprasert F, Srisupundit K, et al. Reference ranges of myocardial performance index from 12 to 40 weeks of gestation [J]. Arch Gynecol Obstet, 2014, 290(5): 859-865.
6
Peixoto AB, Bravo-Valenzuela NJ, Martins WP, et al. Reference ranges for left, right and interventricular septum indices at 20 to 36+6 weeks of gestation derived using spectral myocardial tissue Doppler on Voluson ultrasound machines [J]. Med Ultrason, 2019, 21(3): 279-287.
7
Comas M, Crispi F, Gomez O, et al. Gestational age- and estimated fetal weight-adjusted reference ranges for myocardial tissue Doppler indices at 24-41 weeks' gestation [J]. Ultrasound Obstet Gynecol, 2011, 37(1): 57-64.
8
Oliveira M, Dias JP, Guedes-Martins L. Fetal cardiac function: myocardial performance index [J]. Curr Cardiol Rev, 2022, 18(4): e271221199505.
9
Sun L, Wang J, Su X, et al. Reference ranges of fetal heart function using a modified myocardial performance index: a prospective multicentre, cross-sectional study [J]. BMJ Open, 2021, 11(7): e049640.
10
Nair A, Radhakrishnan S. Fetal left ventricular myocardial performance index: Defining normal values for Indian population and a review of literature [J]. Ann Pediatr Cardiol, 2016, 9(2): 132-136.
11
Zhang L, Han J, Zhang N, et al. Assessment of fetal modified myocardial performance index in early-onset and late-onset fetal growth restriction [J]. Echocardiography, 2019, 36(6): 1159-1164.
12
Palalioglu RM, Erbiyik HI, Kaya B, et al. Investigation of fetal cardiac function using tissue doppler imaging in fetuses compromised by growth restriction [J]. Ginekol Pol, 2021, 92(3): 195-204.
13
Henry A, Alphonse J, Tynan D, et al. Fetal myocardial performance index in assessment and management of small-for-gestational-age fetus: a cohort and nested case-control study [J]. Ultrasound Obstet Gynecol, 2018, 51(2): 225-235.
14
蒋瑜, 杨太珠. 双胎输血综合征胎儿心功能基础及临床应用研究进展 [J].临床超声医学杂志, 2016, (2): 118-120.
15
Zanardini C, Prefumo F, Fichera A, et al. Fetal cardiac parameters for prediction of twin-to-twin transfusion syndrome [J]. Ultrasound Obstet Gynecol, 2014, 44(4): 434-440.
16
Gijtenbeek M, Eschbach SJ, Middeldorp JM, et al. Cardiac time intervals and myocardial performance index for prediction of twin-twin transfusion syndrome [J]. Prenat Diagn, 2021, 41(12): 1498-1503.
17
Ortiz JU, Torres X, Eixarch E, et al. Differential changes in myocardial performance index and its time intervals in donors and recipients of twin-to-twin transfusion syndrome before and after laser therapy [J]. Fetal Diagn Ther, 2018, 44(4): 305-310.
18
Delabaere A, Leduc F, Reboul Q, et al. Prediction of neonatal outcome of TTTS by fetal heart and Doppler ultrasound parameters before and after laser treatment [J]. Prenat Diagn, 2016, 36(13): 1199-1205.
19
Kang OJ, Kim SY, Lee MY, et al. Novel technique for the measurement of fetal right modified myocardial performance index using synchronized images of right ventricular inflow and outflow and clinical application to twin-to-twin transfusion syndrome [J]. J Ultrasound Med, 2021, 40(11): 2467-2475.
20
Assunção RA, Liao AW, de Lourdes Brizot M, et al. Myocardial performance index in fetal anemia [J]. Prenatal diagnosis, 2015, 35(2): 192-196.
21
Luewan S, Tongprasert F, Srisupundit K, et al. Fetal hemodynamic response to anemia in early gestation: using hemoglobin Bart's disease as a study model [J]. Ultraschall Med, 2021(Epub 2021 Nov 8).
22
Tongprasert F, Srisupundit K, Luewan S, et al. Fetal isovolumetric time intervals as a marker of abnormal cardiac function in fetal anemia from homozygous alpha thalassemia-1 disease [J]. Prenat Diagn, 2017, 37(10): 1028-1032.
23
Torigoe F, Ishida H, Ishii Y, et al. Fetal echocardioimagedata prediction score for perinatal mortality in tricuspid valve dysplasia and Ebstein's anomaly [J]. Ultrasound Obstet Gynecol, 2020, 55(2): 226-232.
24
Howley LW, Khoo NS, Moon-Grady AJ, et al. Right atrial dysfunction in the fetus with severely regurgitant tricuspid valve disease: a potential source of cardiovascular compromise [J]. J Am Soc Echocardiogr, 2017, 30(6): 579-588.
25
Axt-Fliedner R, Graupner O, Kawecki A, et al. Evaluation of right ventricular function in fetuses with hypoplastic left heart syndrome using tissue Doppler techniques [J]. Ultrasound Obstet Gynecol, 2015, 45(6): 670-677.
26
Graupner O, Enzensberger C, Wieg L, et al. Evaluation of right ventricular function in fetal hypoplastic left heart syndrome by color tissue Doppler imaging [J]. Ultrasound Obstet Gynecol, 2016, 47(6): 732-738.
27
Wohlmuth C, Wertaschnigg D, Wieser I, et al. Tissue Doppler imaging in fetuses with aortic stenosis and evolving hypoplastic left heart syndrome before and after fetal aortic valvuloplasty [J]. Ultrasound Obstet Gynecol, 2016, 47(5): 608-615.
28
Chen J, Xie L, Dai L, et al. Right heart function of fetuses and infants with large ventricular septal defect: a longitudinal case-control study [J]. Pediatr Cardiol, 2016, 37(8): 1488-1497.
29
Cruz-Lemini M, Valenzuela-Alcaraz B, Granados-Montiel J, et al. Characterizing cardiac dysfunction in fetuses with left congenital diaphragmatic hernia [J]. Prenat Diagn, 2018, 38(6): 422-427.
30
Sun L, Zhang L, Zhang N, et al. Evaluation of hemodynamic changes in fetuses with isolated mild-to-moderate ventriculomegaly by transabdominal ultrasound [J]. J Ultrasound Med, 2020, 39(3): 453-461.
31
Saglam A, Derwig I, Gul M, et al. Foetal cardiac function in third trimester pregnancies with reduced fetal movements [J]. J Obstet Gynaecol, 2022, 42(1): 28-34.
32
Bhorat I, Pillay M, Reddy T. The clinical prognostic significance of myocardial performance index (MPI) in stable placental-mediated disease [J]. Cardiovasc J Afr, 2018, 29(5): 310-316.
33
Bhorat IE, Bagratee JS, Reddy T. Assessment of fetal myocardial performance in severe early onset pre-eclampsia (EO-PET) with and without intrauterine growth restriction across deteriorating stages of placental vascular resistance and links to adverse outcomes [J]. Eur J Obstet Gynecol Reprod Biol, 2017, 210: 325-333.
34
Youssef L, Miranda J, Paules C, et al. Fetal cardiac remodeling and dysfunction is associated with both preeclampsia and fetal growth restriction [J]. Am J Obstet Gynecol, 2020, 222(1): 79 e71-79 e79.
35
Pilania R, Sikka P, Rohit MK, et al. Fetal cardiodynamics by echocardiography in insulin dependent maternal diabetes and its correlation with pregnancy outcome [J]. J Clin Diagn Res, 2016, 10(7): QC01-04.
36
Mohsin M, Sadqani S, Younus K, et al. Evaluation of cardiac function in fetuses of mothers with gestational diabetes [J]. Cardiol Young, 2019, 29(10): 1264-1267.
37
Patey O, Carvalho JS, Thilaganathan B. Perinatal changes in fetal cardiac geometry and function in diabetic pregnancy at term [J]. Ultrasound Obstet Gynecol, 2019, 54(5): 634-642.
38
Bhorat I, Pillay M, Reddy T. Assessment of the fetal myocardial performance index in well-controlled gestational diabetics and to determine whether it is predictive of adverse perinatal outcome [J]. Pediatr Cardiol, 2019, 40(7): 1460-1467.
39
Sanhal CY, Kara O, Yucel A. Can fetal left ventricular modified myocardial performance index predict adverse perinatal outcomes in intrahepatic cholestasis of pregnancy? [J]. J Matern Fetal Neonatal Med, 2017, 30(8): 911-916.
40
Ozel A, Alici Davutoglu E, Eric Ozdemir M, et al. Assessment of fetal left ventricular modified myocardial performance index and its prognostic significance for adverse perinatal outcome in intrahepatic cholestasis of pregnancy [J]. J Matern Fetal Neonatal Med, 2020, 33(12): 2000-2005.
41
Henry A, Welsh AW. Monitoring intrahepatic cholestasis of pregnancy using the fetal myocardial performance index: a cohort study [J]. Ultrasound Obstet Gynecol, 2015, 46(5): 571-578.
42
Morrison JL, Botting KJ, Dyer JL, et al. Restriction of placental function alters heart development in the sheep fetus [J]. Am J Physiol Regul Integr Comp Physiol, 2007, 293(1): R306-R 313.
43
Zhang N, Sun L, Zhang L, et al. Assessment of fetal myocardial performance index in women with placenta previa [J]. Med Sci Monit, 2017, 23: 5933-5942.
44
张娜, 吴青青, 孙丽娟, 等. 心肌做功指数在评价帆状胎盘孕妇胎儿心功能中的应用 [J/CD]. 中华医学超声杂志(电子版), 2019, 16(7): 535-541.
45
Gezer C, Ekin A, Ozeren M, et al. Can the myocardial performance index be used as a new predictive factor for a poor prognosis in fetuses with idiopathic polyhydramnios? [J]. J Ultrasound Med, 2016, 35(12): 2649-2657.
46
Hashemi Attar A, Hafezi F. Fetal myocardial performance index in pregnancies with idiopathic mildly increased amniotic fluid volume [J]. J Clin Ultrasound, 2021, 49(2): 117-123.
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