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Reference values for left and right ventricular systolic-to-diastolic duration ratio (SDR) found using both spectral and tissue Doppler of fetal heart between 20 and 36+6 weeks of gestation

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Abstract

Purpose

To establish reference values for the systolic-to-diastolic duration ratio (SDR) of the left ventricle (LV) using spectral Doppler, as well as for the SDR’ of the interventricular septum (SEP), LV, and right ventricles (RV) using tissue Doppler of the fetal heart.

Method

This prospective and cross-sectional study evaluated 374 low-risk singleton pregnancies from 20 to 36 + 6 weeks of gestation. The ventricular filling time (FT) was obtained from LV inflow using spectral Doppler. Tissue Doppler was used to assess the FT of each ventricle by placing the cursor at the atrioventricular junction marked by the mitral and tricuspid valves, respectively. SDR was calculated as the sum of the isovolumic contraction time (ICT) and the ejection time (ET) divided by the sum of the isovolumic relaxation time (IRT) and the ventricular FT. We used regression analysis to obtain the best-fit model polynomial equation for the parameters. The concordance correlation coefficient (CCC) was used to assess intra- and inter-observer reproducibility.

Results

SDR and SDR’ LV showed a progressive decrease with gestational age (GA); the SDR’ RV and SDR’ SEP did not show a significant decrease with advancing GA. The SDR LV (r = 0.29, p < 0.0001), SDR’ RV (r = 0.21, p < 0.0001), SDR’ LV (r = 0.20, p = 0.0001), and SDR’ SEP (r = 0.25, p < 0.0001) showed a significant weak positive correlation with fetal heart rate. The inter-observer SDR’ SEP measurements demonstrated poor reproducibility (CCC: 0.50), whereas intra-observer SRD LV measurements demonstrated moderate reproducibility (CCC: 0.78).

Conclusions

Reference values for SDR SEP, LV, and RV using spectral and tissue Doppler of fetal heart were established between 20 and 36+6 weeks of gestation.

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Funding

This study was not funded.

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Authors and Affiliations

  1. Department of Obstetrics, Paulista School of Medicine - Federal University of São Paulo (EPM-UNIFESP), Rua Belchior de Azevedo, 156 apto. 111 Torre Vitoria, São Paulo, SP, CEP 05089-030, Brazil

    Alberto Borges Peixoto, Nathalie Jeanne Magioli Bravo-Valenzuela, Rosiane Mattar, Antonio Fernandes Moron, David Baptista da Silva Pares & Edward Araujo Júnior

  2. Mario Palmério University Hospital – University of Uberaba (UNIUBE), Uberaba, MG, Brazil

    Alberto Borges Peixoto

  3. Department of Obstetrics and Gynecology, Federal University of Triângulo Mineiro (UFTM), Uberaba, MG, Brazil

    Alberto Borges Peixoto

  4. Department of Pediatrics, Pediatric and Perinatal Cardiology, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil

    Nathalie Jeanne Magioli Bravo-Valenzuela

  5. Prenatal Diagnostic Service, Department of Obstetrics and Gynecology, Istituto di Ricerca a Carattere Clinico Scientifico (IRCCS), AUSL, Reggio Emilia, Italy

    Gabriele Tonni

Authors
  1. Alberto Borges Peixoto
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  2. Nathalie Jeanne Magioli Bravo-Valenzuela
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  3. Rosiane Mattar
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  4. Antonio Fernandes Moron
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  5. David Baptista da Silva Pares
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  6. Gabriele Tonni
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  7. Edward Araujo Júnior
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Contributions

NJB-V—Data collection / Investigation, ABP—Statistical analysis, DBSP—Methodology, RM—Validation, AFM—Supervision, GT—Critical review, EAJ—Writing.

Corresponding author

Correspondence to Edward Araujo Júnior.

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Conflicts of interest

The authors declare no conflict of interest.

Ethical approval

This study protocol was approved by the Ethics Committee of Federal University of São Paulo (UNIFESP) (CAE: 87111116.4.0000.5505).

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Informed consent was obtained from all participants.

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Peixoto, A.B., Bravo-Valenzuela, N.J.M., Mattar, R. et al. Reference values for left and right ventricular systolic-to-diastolic duration ratio (SDR) found using both spectral and tissue Doppler of fetal heart between 20 and 36+6 weeks of gestation. Int J Cardiovasc Imaging 37, 2717–2726 (2021). https://doi.org/10.1007/s10554-021-02239-7

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  • DOI: https://doi.org/10.1007/s10554-021-02239-7

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