Additional Predictive Importance of Middle Cerebral Artery, Umbilical Artery and Heart for Coarctation of the Aorta in Fetal Ultrasound Parameters

IF 1.6 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques Pub Date : 2025-04-14 DOI:10.1111/echo.70143

Guihong Chen, Wei Xiang, Liman Fu, Yanhong Zhang, Pin Wang, Yongfeng Han, Lu Qin, Qing Guo, Bu-Lang Gao, Congxin Sun

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Abstract

Purpose

To investigate the ultrasound parameter changes in middle cerebral artery (MCA), intra-abdominal and extra-abdominal umbilical artery (UA), and heart for prediction of fetal coarctation of the aorta (CoA).

Materials and Methods

In this prospective one-center control study, 45 true CoA fetuses, 70 false-positive CoA fetuses, and 336 healthy control fetuses at the gestational age 19–40 weeks were prospectively enrolled to undergo ultrasound examination. All the ultrasound parameters of the MCA, intra-abdominal and extra-abdominal UA, and heart were analyzed for the prediction of true CoA in the fetuses.

Results

In the true CoA fetuses compared with the healthy controls, significant (p < 0.05) decreases were present in the peak systolic velocity (PSV)/peak diastolic velocity ratio (S/D), pulsatility index (PI), resistance index (RI) of the MCA, PSV and velocity time integral (VTI) of the UA, MCA to the intra-abdominal UA ratios of the S/D, PI, and RI, left ventricle, tricuspid valve E peak (TV-E), TV-A peak, left cardiac output (LCO), and LCO/body weight, whereas significant (p < 0.05) increases were detected in the UA S/D, PI, and RI, the MCA to the intra-abdominal UA ratios of the PSV and VTI, cardiac axis, right atrium, and right ventricle. Compared with the true CoA fetuses, the false-positive fetuses exhibited significant (p < 0.05) increases in MCA S/D, intra-abdominal UA PSV and VTI, MCA-S/D/intra-abdominal UA S/D, MCA-PI/intra-abdominal UA-PI, MCA-RI/intra-abdominal UA-RI, MCA-S/D/free UA-S/D, MCA-PI/free UA-PI, MCA-RI/free UA-RI, MV-E, MV E/A, TV-E and -A, and LCO/weight, but significant (p < 0.05) decreases in MCA-VTI/intra-abdominal UA-VTI, intra-abdominal UA PI and RI, free UA S/D, free UA PI and RI, and RCO/weight.

Conclusion

Fetuses with CoA have significant alterations in the ultrasound parameters of MCA, intra-abdominal UA, and heart, and significant decreases in MCA RI and the ratio of LCO to fetal weight and ventricular septal defect may significantly affect CoA presence. Fetuses with these ultrasound changes at the gestational age 19–40 weeks should have further examinations for confirmation of CoA presence.

Abstract Image

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胎儿超声参数中大脑中动脉、脐动脉和心脏对主动脉缩窄的额外预测重要性

目的探讨大脑中动脉（MCA）、腹内、腹外脐动脉（UA）及心脏超声参数的变化对胎儿主动脉缩窄（CoA）的预测价值。材料与方法本前瞻性单中心对照研究前瞻性纳入45例CoA真胎、70例CoA假阳性胎和336例胎龄为19 ~ 40周的健康对照胎进行超声检查。分析胎儿MCA、腹内、腹外UA及心脏超声参数，预测胎儿真CoA。结果真CoA胎儿与健康对照组比较，差异有统计学意义(p <；0.05)收缩期峰值速度(PSV)/舒张期峰值速度比（S/D）、心脏搏动指数（PI）、心脏阻力指数（RI）、心脏UA的PSV和速度时间积分（VTI）、心脏收缩期峰值速度(PSV)/腹腔内UA比（S/D）、PI和RI、左心室、三尖瓣E峰（TV-E）、TV-A峰、左心输出量（LCO）和LCO/体重均显著降低(p <；0.05) UA S/D、PI、RI、PSV、VTI、心轴、右心房、右心室MCA /腹腔内UA比值升高。与真CoA胎儿相比，假阳性胎儿表现出显著的(p <；0.05) MCA S/D、腹腔内UA PSV和VTI、MCA-S/D/腹腔内UA S/D、MCA- pi /腹腔内UA- pi、MCA- ri /腹腔内UA- ri、MCA-S/D/游离UA-S/D、MCA- pi /游离UA- pi、MCA- ri /游离UA- ri、MV-E、MV E/A、TV-E和-A、LCO/体重均显著升高(p <；0.05) MCA-VTI/腹腔内UA- vti、腹腔内UA PI和RI、游离UA S/D、游离UA PI和RI、RCO/体重降低。结论CoA胎儿MCA、腹内UA、心脏超声参数明显改变，MCA RI、LCO /胎重比显著降低，室间隔缺损显著影响CoA的存在。在孕龄19-40周出现这些超声变化的胎儿应进一步检查以确认CoA的存在。

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来源期刊

Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques 医学-心血管系统

CiteScore

2.40

自引率

6.70%

发文量

211

审稿时长

3-6 weeks

期刊介绍： Echocardiography: A Journal of Cardiovascular Ultrasound and Allied Techniques is the official publication of the International Society of Cardiovascular Ultrasound. Widely recognized for its comprehensive peer-reviewed articles, case studies, original research, and reviews by international authors. Echocardiography keeps its readership of echocardiographers, ultrasound specialists, and cardiologists well informed of the latest developments in the field.