Cardiac function in fetuses with intracardiac echogenic foci

Objective To evaluate cardiac dimensions and function in euploid fetuses wi th intracardiac echogenic foci. Study design Forty-eight fetuses with a single cardiac echogenic focus situ ated in the left ventricle had echocardiography performed at 22-24 weeks of gestation. Fifty normal fetuses at 22-24 weeks' gestation served as contro ls. Two-dimensional and M-mode directed fetal echocardiography were used to exclude cardiac anomalies and measure right and left ventricular free wall s and interventricular septal thickness and ventricular systolic and diasto lic dimensions. Cardiac size was expressed as a ratio of ventricular wall t hickness/biparietal diameter, and cardiac function was expressed as ventric ular shortening fraction. Doppler fetal echocardiography measurements inclu ded pulmonary and aortic maximum systolic velocities and time to peak veloc ities as indices of ventricular systolic function, and the ratio between ea rly ventricular filling (E-wave) and active atrial filling (A-wave) peak ve locities at the level of the atrioventricular valves as an index of ventric ular diastolic function. Results Early ventricular filling/active atrial filling peak velocity ratio s were significantly lower in fetuses with intracardiac echogenic foci than in control fetuses. In the mitral valve the ratio was 0.37 +/-0.14 (0.039) (mean +/- SD (95% confidence interval for difference between the means)) v s. 0.59 +/-0.19 (0.052) and in the tricuspid valve it was 0.42 +/-0.16 (0.0 45) vs. 0.62 +/-0.21 (0.058). No significant differences were found in card iac dimensions, ventricular shortening fraction and Doppler systolic indice s. Conclusion Euploid fetuses with intracardiac echogenic foci show low E/A ra tio values in midtrimester echocardiography. This finding might indicate ca rdiac diastolic dysfunction.