Valley Index as a Predictor of Prenatal Diagnosis of Total Anomalous Pulmonary Venous Connection.

IF 1.6 3区医学 Q3 OBSTETRICS & GYNECOLOGY Fetal Diagnosis and Therapy Pub Date : 2024-01-01 Epub Date: 2024-05-20 DOI:10.1159/000539314

Wakako Maruyama, Yuki Kawasaki, Yosuke Murakami, Mitsuhiro Fujino, Takeshi Sasaki, Kae Nakamura, Yoko Yoshida, Tsugutoshi Suzuki, Kenichi Kurosaki, Taiyu Hayashi, Hiroshi Ono, Eiji Ehara

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Abstract

Introduction: Total anomalous pulmonary venous connection (TAPVC) has a low prenatal diagnostic rate. Therefore, we investigated whether Doppler waveforms with a low pulsatility in the pulmonary veins can indicate fetal TAPVC.

Methods: This retrospective study included 16 fetuses with TAPVC, including 10 with complex congenital heart disease and 104 healthy fetuses that underwent fetal echocardiography. Pulmonary venous S and D wave flow velocities and the valley (representing the lowest velocity between the S and D waves) were measured. Valley indices I and II were then calculated as (velocity of valley/greater of the S and D wave velocities) and (velocity of valley/lesser of the S and D wave velocities), respectively.

Results: Supra/infracardiac TAPVC cases exhibited significantly greater valley indices than that of the healthy group. After adjusting for gestational age at fetal echocardiography, valley indices I (odds ratio [OR] 7.26, p < 0.01) and II (OR: 9.23, p < 0.01) were significant predictors of supra/infracardiac TAPVC. Furthermore, valley indices I and II exhibited a high area under the curve for detecting supra/infracardiac TAPVC, regardless of the presence of pulmonary venous obstruction.

Conclusion: The valley index may be a useful tool for the detection of fetal TAPVC.

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山谷指数是产前诊断全肺静脉连接异常的预测指标。

简介全异常肺静脉连接（TAPVC）的产前诊断率很低。因此，我们研究了肺静脉低搏动多普勒波形是否能提示胎儿TAPVC：这项回顾性研究纳入了 16 个患有 TAPVC 的胎儿，包括 10 个患有复杂先天性心脏病的胎儿和 104 个接受了胎儿超声心动图检查的健康胎儿。测量了肺静脉 S 波和 D 波流速及谷值（代表 S 波和 D 波之间的最低流速）。溪谷指数 I 和 II 分别以（溪谷速度/S 波和 D 波速度的较大值）和（溪谷速度/S 波和 D 波速度的较小值）计算：结果：心上/心内TAPVC病例的波谷指数明显高于健康组。在对胎儿超声心动图检查时的胎龄进行调整后，溪谷指数 I（比值比 [OR] 7.26，p < 0.01）和溪谷指数 II（比值比 9.23，p < 0.01）是预测心上/心内 TAPVC 的重要指标。此外，无论是否存在肺静脉阻塞，山谷指数 I 和 II 在检测心上/心内 TAPVC 方面均表现出较高的曲线下面积：结论：山谷指数可能是检测胎儿 TAPVC 的有用工具。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Fetal Diagnosis and Therapy 医学-妇产科学

CiteScore

4.70

自引率

9.10%

发文量

审稿时长

6-12 weeks

期刊介绍： The first journal to focus on the fetus as a patient, ''Fetal Diagnosis and Therapy'' provides a wide range of biomedical specialists with a single source of reports encompassing the common discipline of fetal medicine.