G. Tulzer et al., DIASTOLIC FUNCTION OF THE FETAL HEART DURING 2ND AND 3RD TRIMESTER - A PROSPECTIVE LONGITUDINAL DOPPLER-ECHOCARDIOGRAPHIC STUDY, European journal of pediatrics, 153(3), 1994, pp. 151-154
To generate normal charts of fetal cardiac inflow velocities and to as
sess physiologic changes of ventricular diastolic function, velocity w
aveforms of tricuspid and mitral valves were studied longitudinally in
49 fetuses in 4 week intervals from 14 weeks gestation to term. Doppl
er tracings were analyzed for: peak early (E) and peak late (A) inflow
velocities, time velocity integral (TVI) of total inflow and A-wave v
elocity waveforms and heart rate corrected isovolemic relaxation time.
E- and A-velocity as well as total- and A-wave-TVI of both valves inc
reased significantly with gestational age (P<0.001). Heart rate and A/
E ratio decreased significantly with gestational age (P < 0.001). The
ratio of A-wave TVI to total TVI of both valves and heart rate correct
ed isovolemic relaxation time (TVI) was constant suggesting unchanged
diastolic function. This study provides normal charts for fetal cardia
c inflow velocities. After 14 weeks of gestation all inflow velocities
and their respective TVI's increased linearly in the growing fetal he
art. There was evidence that diastolic function did not change. Area r
atios and IVR should be used to determine changes in ventricular diast
olic function, rather than velocity ratios.