Fetal Echocardiographic Dimension Indices: Important Predictors of Postnatal Coarctation
(2021) In Pediatric Cardiology 42(3). p.517-525- Abstract
- The aim of the study is to identify reliable quantitative fetal echocardiographic predictors for postnatal development of coarctation (CoA). In this retrospective study, we included 65 fetuses with a prenatally suspected, isolated CoA, born 2010–2018. Dimensions of the cardiac structures, aortic, and ductal arches expressed as ratios and Z-scores were analyzed in relation to outcome. Fetuses that developed CoA postnatally (34%) exhibited significantly smaller Z-scores of left cardiac structures from the mitral valve to the aortic isthmus. The most sensitive and specific predictors were a carotid-subclavian artery index (CSAI) of < 0.78 (92.3% sensitivity, 96.8% specificity) or a product of isthmus-to-duct ratio in the three-vessel... (More)
- The aim of the study is to identify reliable quantitative fetal echocardiographic predictors for postnatal development of coarctation (CoA). In this retrospective study, we included 65 fetuses with a prenatally suspected, isolated CoA, born 2010–2018. Dimensions of the cardiac structures, aortic, and ductal arches expressed as ratios and Z-scores were analyzed in relation to outcome. Fetuses that developed CoA postnatally (34%) exhibited significantly smaller Z-scores of left cardiac structures from the mitral valve to the aortic isthmus. The most sensitive and specific predictors were a carotid-subclavian artery index (CSAI) of < 0.78 (92.3% sensitivity, 96.8% specificity) or a product of isthmus-to-duct ratio in the three-vessel trachea view (3VT) and the mitral-to-tricuspid valve ratio (I/D3VTxMV/TV) of < 0.37 (100% sensitivity, 94.6% specificity). When comparing different Z-score datasets, we observed large and highly significant differences. Postnatal CoA can be predicted with high accuracy during fetal life using CSAI or I/D3VTxMV/TV. The latter may be particularly useful if adequate sagittal aortic arch images cannot be obtained. As significant and clinically unacceptable differences in Z-scores were observed for the same measurements, this calls for a large multi-center collaboration to generate reliable fetal echocardiographic Z-scores. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/d9564969-6b1f-48df-934c-c29d8369ac24
- author
- Fricke, Katrin LU ; Liuba, Petru LU and Weismann, Constance Gesina LU
- organization
- publishing date
- 2021
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Pediatric Cardiology
- volume
- 42
- issue
- 3
- pages
- 517 - 525
- publisher
- Springer
- external identifiers
-
- scopus:85099518729
- pmid:33355680
- ISSN
- 0172-0643
- DOI
- 10.1007/s00246-020-02509-6
- language
- English
- LU publication?
- yes
- id
- d9564969-6b1f-48df-934c-c29d8369ac24
- date added to LUP
- 2020-12-25 16:33:19
- date last changed
- 2024-01-17 18:21:31
@article{d9564969-6b1f-48df-934c-c29d8369ac24, abstract = {{The aim of the study is to identify reliable quantitative fetal echocardiographic predictors for postnatal development of coarctation (CoA). In this retrospective study, we included 65 fetuses with a prenatally suspected, isolated CoA, born 2010–2018. Dimensions of the cardiac structures, aortic, and ductal arches expressed as ratios and Z-scores were analyzed in relation to outcome. Fetuses that developed CoA postnatally (34%) exhibited significantly smaller Z-scores of left cardiac structures from the mitral valve to the aortic isthmus. The most sensitive and specific predictors were a carotid-subclavian artery index (CSAI) of < 0.78 (92.3% sensitivity, 96.8% specificity) or a product of isthmus-to-duct ratio in the three-vessel trachea view (3VT) and the mitral-to-tricuspid valve ratio (I/D3VTxMV/TV) of < 0.37 (100% sensitivity, 94.6% specificity). When comparing different Z-score datasets, we observed large and highly significant differences. Postnatal CoA can be predicted with high accuracy during fetal life using CSAI or I/D3VTxMV/TV. The latter may be particularly useful if adequate sagittal aortic arch images cannot be obtained. As significant and clinically unacceptable differences in Z-scores were observed for the same measurements, this calls for a large multi-center collaboration to generate reliable fetal echocardiographic Z-scores.}}, author = {{Fricke, Katrin and Liuba, Petru and Weismann, Constance Gesina}}, issn = {{0172-0643}}, language = {{eng}}, number = {{3}}, pages = {{517--525}}, publisher = {{Springer}}, series = {{Pediatric Cardiology}}, title = {{Fetal Echocardiographic Dimension Indices: Important Predictors of Postnatal Coarctation}}, url = {{http://dx.doi.org/10.1007/s00246-020-02509-6}}, doi = {{10.1007/s00246-020-02509-6}}, volume = {{42}}, year = {{2021}}, }