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Chinese Journal of Medical Ultrasound (Electronic Edition) >
2021 , Vol. 18 >Issue 07: 681 - 687
DOI: https://doi.org/10.3877/cma.j.issn.1672-6448.2021.07.012
Application of three Doppler methods in quantitative measurement of fetal atrioventricular conduction time
Received date: 2020-03-25
Online published: 2021-07-16
To establish the normal range of fetal atrioventricular (AV) time intervals during the second and third trimesters assessed by three different pulsed-wave Doppler techniques [superior vena cava and ascending aorta (SVC/AAO) method, tissue Doppler imaging (TDI), and pulmonary artery and pulmonary vein (PA/PV) method and analyze the correlation of AV value with gestational age, fetal heart rate, and heart area.
From June to December 2019, 227 normal fetuses who underwent echocardiography at the Sir Run Run Shaw Hospital of Zhejiang University College of Medicine were selected. The gestational age was 16 to 41 weeks. They were divided into five groups according to gestational age. Pulsed-wave Doppler methods including SVC/AAO, TDI, and PA/PV were applied to measure AV, respectively. The measurement success rate and the normal range of AV values in different gestational weeks were obtained. Single-factor analysis of variance and multiple comparisons (LSD-t method) were used to analyze the differences in AV values obtained by different methods. Pearson correlation analysis was performed to examine the correlation of AV values with gestational age, fetal heart rate, and fetal heart area. Intraclass correlation coefficient (ICC) was used to evaluate the in-observer and inter-observer repeatability of each method.
All the three Doppler methods achieved a high measurement success rate: SVC/AAO, 94.58%; TDI, 100%; PA/PV, 95.83%. The normal range of AV values was: AV-SVC/AAO, (115.94±6.67) ms; AV-TDI, (117.69±6.43) ms; AV-PA/PV,(123.70±6.42 )ms; the difference between them was statistically significant (t=-2.843, -12.662, -9.819; P=0.005, ＜0.001, ＜0.001). All AV values were positively correlated with gestational age (r=0.677~0.680, P＜0.001) and fetal heart area (r=0.648~0.654, P＜0.001), but negatively correlated with fetal heart rate (r=-0.568~-0.581, P＜0.001). In-observer and inter-observer repeatability tests showed that the three Doppler methods had good repeatability (ICC＞0.80).
All the three Doppler methods are feasible and reproducible in measuring fetal heart AV values; normal fetal AV values in the second and third trimesters are affected by gestational age, fetal heart area, and fetal heart rate, and there are differences in AV values measured by different methods. Therefore, choosing an appropriate method to measure the fetal AV time and understanding the difference between the measured values by different methods are very important in clinical work and have very important significance.
Mei Pan , Bowen Zhao , Yankai Mao , Xiaohui Peng , Yuan Yang , Bei Wang , Xiaolu Sun , Jun Wu . Application of three Doppler methods in quantitative measurement of fetal atrioventricular conduction time[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2021 , 18(07) : 681 -687 . DOI: 10.3877/cma.j.issn.1672-6448.2021.07.012
| 1 | Zhao BW,Zhang SY,Pan M,et al. Clinical applications of fetal echocardiography in detection of fetal arrhythmia: a retrospective evaluation of 451 fetuses [J]. Chin Med, 2004, 117(3): 474-477. |
| 2 | Behar JA, Bonnemains L, Shulgin V, et al. Noninvasive fetal electrocardiography for the detection of fetal arrhythmias [J]. Prenat Diagn, 2019, 39(3): 178-187. |
| 3 | 王鸿, 耿丹明, 李慧忠, 等. 多普勒超声对正常胎儿心脏机械性PR间期的临床研究 [J/CD].中华医学超声杂志(电子版), 2009, 6(6): 1001-1006. |
| 4 | Kurihara Y, Tachibana D, Yokoi N, et al. Time-interval changes of cardiac cycles in fetal growth restriction [J]. Eur J Obstet Gynecol Reprod Biol, 2016, 203(8): 152-155. |
| 5 | Anuwutnavin S, Kolakarnprasert K, Chanprapaph P, et al. Measurement of fetal atrioventricular time intervals: a comparison of 3 spectral Doppler techniques [J]. Prenat Diagn, 2018, 38(6): 459-466. |
| 6 | Howley LW, Schuchardt E, Park D, et al. Simultaneous recording of pulsed-wave Doppler signals in innominate vein and transverse aortic arch: new technique to evaluate atrioventricular conduction and fetal heart rhythm [J]. Ultrasound Obstet Gynecol, 2018, 52(4): 544-545. |
| 7 | 吴俊, 赵博文, 彭晓慧, 等. 胎儿肺动静脉Doppler血流频谱同步记录法测量胎儿心脏传导时间的应用研究 [J]. 中华超声影像学杂志, 2018, 27(3): 66-70. |
| 8 | Ryehik J, Ayres N, Cuneo B, et al. American Society of Echocardiography guidelines and standards for performance of the fetal echocardiogram [J]. Am Soc Echocardiogr, 2004, 17(7): 803-810. |
| 9 | Cuneo BF, Bitant S, Strasburger JF, et al. Assessment of atrioventricular conduction by echocardiography and magnetocardiography in normal and anti-Ro/SSA-antibody-positive pregnancies [J]. Ultrasound Obstet Gynecol, 2019, 54(5): 625-633. |
| 10 | Evers PD, Alsaied T, Anderson JB, et al. Prenatal heart block screening in mothers with SSA/SSB autoantibodies: Targeted screening protocol is a cost-effective strategy [J]. Congenit Heart Dis, 2019, 14(2): 221-229. |
| 11 | Friedman DM, Kim MY, Copel JA, et al. Utility of cardiac monitoring in fetuses at risk for congenital heart block: the PR Interval and Dexa-methasone Evaluation (PRIDE) prospective study [J]. Circulation, 2008, 117(4): 485-493. |
| 12 | Mosimann B, Arampatzis G, Amylidi-Mohr S, et al. Reference ranges for fetal atrioventricular and ventriculoatrial time intervals and their ratios during normal pregnancy [J]. Fetal Diagn Ther, 2018, 44(3): 228-235. |
| 13 | Andelfinger G, Fouron JC, Sonesson SE, et al. Reference values for time intervals between atrial and ventricular contractions of the fetal heart measured by two doppler techniques [J]. Am J Cardiol, 2001, 88(12): 1433-1436. |
| 14 | Bergman G, Jacobsson LA, Wahren-Herlenius M, et al. Doppler echocardiographic and electrocardiographic atrioventricular time intervals in newborn infants: evaluation of techniques for surveillance of foetuses at risk for congenital heart block [J]. Ultrasound Obstet Gynecol, 2006, 28(1): 57-62. |
| 15 | Sonesson SE, Ambrosi A, Wahren-Herlenius M, et al. Benefits of fetal echocardiographic surveillance in pregnancies at risk of congenital heart block: single-center study of 212 anti-Ro52-positive pregnancies [J]. Ultrasound Obstet Gynecol, 2019, 54(1): 87-95. |
| 16 | 杨园, 赵博文, 潘美, 等. 组织多普勒与脉冲多普勒超声评价胎儿心脏传导时间的定量研究 [J]. 中华超声影像学杂志, 2008, 17(9): 753-758. |
| 17 | Nii M, Shimizu M, Roman KS, et al. Doppler tissue imaging in the assessment of atrioventricular conduction time: validation of novel technique and comparison with electrophysiologic and pulsed wave doppler-derived equivalents in an animal model [J]. J Am Soc Echocardiogr, 2006, 19(3): 314-321. |
| 18 | Glickstein JS, Buyon J, Friedman D, et al. Pulsed Doppler echocardiographic assessment of the fetal PR interval [J]. Am J Cardiol, 2000, 86(2): 236-239. |
| 19 | Bolnick AD, Borgida AF, Egan JF, et al. Influence of gestational age and fetal heart rate on the fetal mechanical PR interval [J]. J Matern Fetal Neonatal Med, 2004, 15(5):303-305. |
| 20 | Van Leeuwen P, Schiermeier S, Lange S, et al. Gender-related changes in magnetocardiographically determined fetal cardiac time intervals in intrauterine growth retardation [J]. Pediatr Res, 2006, 59(6): 820-824. |
| 21 | Wheeler T, Murrills A. Patterns of fetal heart rate during normal pregnancy [J]. Br J Obstet Gynaecol, 1978, 85(1): 18-27. |
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