J Cardiovasc Ultrasound.  2012 Jun;20(2):85-89. 10.4250/jcu.2012.20.2.85.

Atrioventricular Flow Wave Patterns before and after Birth by Fetal Echocardiography

Affiliations
  • 1Department of Pediatrics, School of Medicine, Ewha Womans University, Seoul, Korea. hongym@chol.com

Abstract

BACKGROUND
Doppler echocardiographic measurements of both valves during intrauterine life can be used to calculate peak early filling velocity (E)/late peak atrial filling velocity (A) ratio as a single index of diastolic performance. The purposes of this study were to estimate the changes in atrioventricular valve flow from gestational age 37-40 weeks to 1 month of postnatal life and to clarify the difference in right and left ventricular diastolic filling patterns.
METHODS
Atrioventricular flow waves were analyzed in 24 full-term pregnant women by fetal echocardiography. Postnatal follow-up studies were performed at 1 hour, 6 hours, 24 hours, 3 days, 1 week and 1 month. In each time point, pulsed Doppler echocardiography was used to interrogate Doppler waveform of E velocity, A velocity, total area under the curve (time velocity integral) and heart rate.
RESULTS
Mitral E/A ratio significantly increased from 0.7 +/- 0.1 before birth to 1.0 +/- 0.3 at postnatal 1 hour, 1.0 +/- 0.2 at 1 week, and 1.5 +/- 1.0 at 1 month. Tricuspid flow E/A ratio was 0.8 +/- 0.3 before birth, 0.8 +/- 0.1 at 1 hour, 0.8 +/- 0.2 at 3 days, 0.9 +/- 1.0 at 1 month. Time velocity integral of tricuspid flow was significantly higher than that of mitral flow before birth, but there was no difference after birth.
CONCLUSION
The dominance of mitral A wave before birth was changed very quickly after birth to the dominance of E wave, but the dominance of tricuspid A wave was maintained at 1 month. Diastolic function and compliance of mitral valve were better than those of the tricuspid valve after birth.

Keyword

Fetal echocardiography; Atrioventricular valve flow

MeSH Terms

Compliance
Echocardiography
Echocardiography, Doppler, Pulsed
Female
Follow-Up Studies
Gestational Age
Heart
Humans
Mitral Valve
Parturition
Pregnant Women
Tricuspid Valve

Figure

  • Fig. 1 Changes of mitral wave velocity according to age. *p < 0.05. E: peak early filling velocity, A: late peak atrial filling velocity.

  • Fig. 2 Change of E/A ratio according to age. *p < 0.05. E: peak early filling velocity, A: late peak atrial filling velocity.

  • Fig. 3 Change of tricuspid wave velocity according to age. E: peak early filling velocity, A: late peak atrial filling velocity.

  • Fig. 4 Change of atrioventricular valve time velocity integral according to age


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