Assessment of left ventricular filling in normally grown fetuses, growth-restricted fetuses and fetuses of diabetic mothers. 1998

P Tsyvian, and K Malkin, and O Artemieva, and J W Wladimiroff
Laboratory of Biophysics, Mother and Child Institute, Ekaterinburg, Russia.

OBJECTIVE To determine fetal left ventricular diastolic function as expressed by normalized left ventricular filling rate integral as well as conventional indices of transmitral blood flow in appropriate-for-gestational-age (AGA), small-for-gestational-age (SGA) and IDDM (insulin-dependent diabetes mellitus) fetuses during the third trimester of pregnancy. METHODS A cross-sectional study of fetal left ventricular filling using conventional parameters of transmitral blood flow. METHODS Twenty-five AGA fetuses (mean 32 weeks), 18 SGA fetuses (mean 32 weeks) and 15 fetuses associated with IDDM (mean 31 weeks). METHODS Doppler measurements of mitral inflow velocity were converted to relative cumulative volume flow by integration at sequential time points along the velocity contour, producing a relative filling curve of the ventricle. The area under this curve was calculated to obtain the left ventricular filling rate integral. RESULTS The left ventricular filling rate integral (I) for the complete diastole (E + A wave) was not significantly different between AGA and SGA fetuses but significantly lower in the IDDM fetus (p < 0.05) compared with the AGA fetus. Ie (E wave) was significantly lower and Ia (A wave) significantly higher in both SGA fetuses (p < 0.05) and IDDM fetuses (p < 0.01) compared with AGA fetuses. CONCLUSIONS There is a delay in left ventricular filling which may reflect changes in myocardial relaxation and possible reduction in passive ventricular filling as a result of chronic hypoxemia in the SGA fetus and altered in utero metabolic environment in the IDDM fetus.

UI MeSH Term Description Entries
D007231 Infant, Newborn An infant during the first 28 days after birth. Neonate,Newborns,Infants, Newborn,Neonates,Newborn,Newborn Infant,Newborn Infants
D007236 Infant, Small for Gestational Age An infant having a birth weight lower than expected for its gestational age.
D009200 Myocardial Contraction Contractile activity of the MYOCARDIUM. Heart Contractility,Inotropism, Cardiac,Cardiac Inotropism,Cardiac Inotropisms,Contractilities, Heart,Contractility, Heart,Contraction, Myocardial,Contractions, Myocardial,Heart Contractilities,Inotropisms, Cardiac,Myocardial Contractions
D011247 Pregnancy The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH. Gestation,Pregnancies
D011254 Pregnancy in Diabetics The state of PREGNANCY in women with DIABETES MELLITUS. This does not include either symptomatic diabetes or GLUCOSE INTOLERANCE induced by pregnancy (DIABETES, GESTATIONAL) which resolves at the end of pregnancy. Pregnancy in Diabetes,Pregnancy in Diabete,Pregnancy in Diabetic
D011263 Pregnancy Trimester, Third The last third of a human PREGNANCY, from the beginning of the 29th through the 42nd completed week (197 to 294 days) of gestation. Pregnancy, Third Trimester,Trimester, Third,Last Trimester,Last Trimesters,Pregnancies, Third Trimester,Pregnancy Trimesters, Third,Third Pregnancy Trimester,Third Pregnancy Trimesters,Third Trimester,Third Trimester Pregnancies,Third Trimester Pregnancy,Third Trimesters,Trimester, Last,Trimesters, Last,Trimesters, Third
D012016 Reference Values The range or frequency distribution of a measurement in a population (of organisms, organs or things) that has not been selected for the presence of disease or abnormality. Normal Range,Normal Values,Reference Ranges,Normal Ranges,Normal Value,Range, Normal,Range, Reference,Ranges, Normal,Ranges, Reference,Reference Range,Reference Value,Value, Normal,Value, Reference,Values, Normal,Values, Reference
D003922 Diabetes Mellitus, Type 1 A subtype of DIABETES MELLITUS that is characterized by INSULIN deficiency. It is manifested by the sudden onset of severe HYPERGLYCEMIA, rapid progression to DIABETIC KETOACIDOSIS, and DEATH unless treated with insulin. The disease may occur at any age, but is most common in childhood or adolescence. Diabetes Mellitus, Brittle,Diabetes Mellitus, Insulin-Dependent,Diabetes Mellitus, Juvenile-Onset,Diabetes Mellitus, Ketosis-Prone,Diabetes Mellitus, Sudden-Onset,Diabetes, Autoimmune,IDDM,Autoimmune Diabetes,Diabetes Mellitus, Insulin-Dependent, 1,Diabetes Mellitus, Type I,Insulin-Dependent Diabetes Mellitus 1,Juvenile-Onset Diabetes,Type 1 Diabetes,Type 1 Diabetes Mellitus,Brittle Diabetes Mellitus,Diabetes Mellitus, Insulin Dependent,Diabetes Mellitus, Juvenile Onset,Diabetes Mellitus, Ketosis Prone,Diabetes Mellitus, Sudden Onset,Diabetes, Juvenile-Onset,Diabetes, Type 1,Insulin Dependent Diabetes Mellitus 1,Insulin-Dependent Diabetes Mellitus,Juvenile Onset Diabetes,Juvenile-Onset Diabetes Mellitus,Ketosis-Prone Diabetes Mellitus,Sudden-Onset Diabetes Mellitus
D003971 Diastole Post-systolic relaxation of the HEART, especially the HEART VENTRICLES. Diastoles
D005260 Female Females

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