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Reference ranges and Z-scores of atrioventricular and ventriculoatrial time intervals in normal fetuses

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Abstract

Objective

To establish a reference range and compare differences among three methods, and then to construct Z-score reference ranges in normal fetuses from the three methods to provide an extra tool for fetal conduction time assessment.

Methods

A total of 227 echocardiographic examinations were finally included. Fetal atrioventricular (AV) time and ventriculoatrial (VA) time intervals were measured by three methods: superior vena cava/ascending aorta (SVC/AAO), pulmonary artery/pulmonary vein (PA/PV) and tissue Doppler imaging (TDI). Regression analysis of the mean and standard deviation was performed to establish Z-scores.

Results

With the three methods, positive correlations of intervals with gestational age (GA) and fetal heart rate (FHA) were observed, while intervals were negatively correlated with fetal heart rate (FHR). Correlations between VA/AV and GA, FHA and FHR were weak. The general trend of all intervals was towards an increase. In AV intervals, PA/PV revealed the longest mean AV time interval and SVC/AAO showed the shortest interval. In addition, PA/PV revealed the shortest VA interval.

Conclusion

This study presents not only the reference range of AV and VA intervals with the three methods but also the Z-score reference ranges for these indices against GA and FHA in normal fetuses. Each method has a different reference range, and appropriate application can facilitate diagnosis and treatment.

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Funding

This work was supported by the Zhejiang Provincial Natural Science Foundation under Zhejiang Province Public Welfare Technology Application Research Project (Grant No. LGF18H180004).

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Authors and Affiliations

  1. Department of Diagnostic Ultrasound and Echocardiography, Sir Run Run Shaw Hospital, Zhejiang University College of Medicine, No.3 East Qingchun Road, Hangzhou, 310016, China

    Mei Pan, Ming-Xuan Zhang, Bo-Wen Zhao, Yan-Kai Mao, Xiao-Hui Peng, Yuan Yang & Bei Wang

Authors
  1. Mei Pan
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  2. Ming-Xuan Zhang
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  3. Bo-Wen Zhao
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  4. Yan-Kai Mao
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  5. Xiao-Hui Peng
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  6. Yuan Yang
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  7. Bei Wang
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Contributions

MP contributed to manuscript drafting; M-XZ reviewed the literature and contributed to manuscript drafting; B-WZ and BW were responsible for the revision of the manuscript for important intellectual content; Y-KM, X-HP and YY, as the patient’s sonographers, collected the echocardiograms. All authors issued final approval for the version to be submitted.

Corresponding author

Correspondence to Ming-Xuan Zhang.

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The authors report no conflicts of interest.

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Pan, M., Zhang, MX., Zhao, BW. et al. Reference ranges and Z-scores of atrioventricular and ventriculoatrial time intervals in normal fetuses. Int J Cardiovasc Imaging 37, 2419–2428 (2021). https://doi.org/10.1007/s10554-021-02217-z

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  • DOI: https://doi.org/10.1007/s10554-021-02217-z

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