Navegando por Palavras-chave "Fetal heart"
Agora exibindo 1 - 8 de 8
Resultados por página
Opções de Ordenação
- ItemSomente MetadadadosAssessment of the Fetal Heart at 12-14 Weeks of Pregnancy Using B-Mode, Color Doppler, and Spatiotemporal Image Correlation via Abdominal and Vaginal Ultrasonography(Springer, 2013-10-01) Felipe Lima, Angelia Iara [UNIFESP]; Araujo Junior, Edward [UNIFESP]; Martins, Wellington P.; Machado Nardozza, Luciano Marcondes [UNIFESP]; Moron, Antonio Fernandes [UNIFESP]; Silva Pares, David Baptista [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade de São Paulo (USP); Ultrasonog & Retraining Med Sch Ribeirao Preto EUThis study aimed to evaluate the effect that combining multiple ultrasonographic imaging methods has on the proportion of tests with a satisfactory fetal heart assessment at 12-14 weeks of pregnancy using B-mode, color Doppler, and spatiotemporal image correlation software (STIC) via both the abdominal and vaginal routes. This cross-sectional prospective study involved healthy pregnant women at 12-14 weeks of pregnancy with a crown-rump length (CRL) of 84 mm or shorter. the following four cardiac views were assessed: four-chamber, left and right ventricular outflow tract, and aortic arch views. the same examiner sought to identify these four views using B-mode, color Doppler, and STIC via both the vaginal and abdominal routes. the study determined the proportion of cases and the respective 95 % confidence intervals (CIs) in which all four views were identified. the presence of significant differences in comparisons between methods was analyzed using McNemar's test. Although 57 pregnant women at 12-14 weeks of pregnancy agreed to participate in the study, 4 were not included because they presented with a CRL longer than 84 mm. Thus, 53 pregnant women were thoroughly assessed and included in the analysis. the combination of B-mode, color Doppler, and STIC via both the abdominal and vaginal routes enabled the highest proportion of identification of the four views (90.6 %; 95 % CI, 79.8-95.9 %). the lowest proportions were observed when B-mode was used alone via both the vaginal route (30.2 %; 95 % CI, 19.5-43.5 %) and the abdominal route (37.7 %; 95 % CI, 25.9-51.2 %). the abdominal route showed results slightly better than those of the vaginal route with all the methods, but the differences were not statistically significant. in the vast majority of the cases, the fetal hearts were properly assessed at 12-14 weeks of pregnancy when several methods were combined using both the abdominal and vaginal routes. However, only one-third of them would have had adequate heart assessment if the B-mode via either the abdominal or the vaginal route had been used alone.
- ItemAcesso aberto (Open Access)Avaliação da evolução da área das valvas mitral e tricúspide fetal com ultrassonografia tridimensional(Federação Brasileira das Sociedades de Ginecologia e Obstetrícia, 2010-09-01) Rolo, Liliam Cristine [UNIFESP]; Nardozza, Luciano Marcondes Machado [UNIFESP]; Araujo Júnior, Edward [UNIFESP]; Simioni, Christiane [UNIFESP]; Zamith, Marina Maccagnano [UNIFESP]; Moron, Antonio Fernandes [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)PURPOSE: to evaluate the areas of the atrioventricular valves (tricuspid and mitral) of normal fetuses by the use of three-dimensional ultrasound (3DUS) and the spatiotemporal image correlation (STIC) method. METHODS: a cross-sectional study was conducted on 141 women between the 18th and the 33rd week of pregnancy. Cardiac volumes were measured with a volumetric transabdominal transducer attached to the Voluson 730 Expert equipment. The four chamber plane was used as reference, with the region of interest (ROI) positioned from the ventricles, and the area of the valves was obtained manually. To determine the correlation of the areas with gestational age, scatter plots were constructed and the Pearson correlation coefficient (r) was calculated. Means, medians, standard deviations (SD) and maximum and minimum values were calculated. The simple linear regression model was used to determine reference ranges of valve areas according to the gestational age by the Altman method, with the level of significance set at p<0.05. To calculate the intraobserver reproducibility, we used the intraclass correlation coefficient (ICC) and the Bland-Altman graph. RESULTS: the mitral and tricuspid valve areas were correlated to the gestational age (r=0.80 for the tricuspid and r=0.79 for the mitral valve) and the mean value of the tricuspid and mitral valves increased from 0.22±0.10 cm² and 0.23±0.10 cm² on the 18th week to 0.92±0.29 cm² and 1.08±0.41 cm² on the 33rd of pregnancy, respectively. The intraobserver reproducibility resulted in an ICC=0.993 (95%CI 0.987; 0.996) and the mean difference was 0.01 cm² (SD±0.2 cm² and CI95%±0.4 cm²). CONCLUSION: reference intervals for the areas of the mitral and tricuspid valve between the 18th and the 33rd week of gestation were determined and proved to be highly reproducible.
- ItemAcesso aberto (Open Access)Avaliação da geometria do coração fetal por meio da ultrassonografia tridimensional pelo método STIC renderização(Universidade Federal de São Paulo (UNIFESP), 2017-12-18) Bezerra, Marilim de Souza [UNIFESP]; Araujo Júnior, Edward [UNIFESP]; Rolo, Liliam Cristine [UNIFESP]; http://lattes.cnpq.br/7732742031806411; http://lattes.cnpq.br/5327493355945437; Universidade Federal de São Paulo (UNIFESP)Objetivos: Determinar a geometria do coração fetal ao longo da gestação segundo a medida dos seus ângulos internos por meio da ultrassonografia tridimensional (3D) pelo método spatio-temporal image correlation (STIC) renderização e avaliar as reprodutibilidades intra e interobservador dos ângulos cardíacos fetais. Métodos: Realizou-se um estudo prospectivo transversal com 250 gestações únicas normais entre 20 e 33 semanas e 6 dias. A partir do plano de quatro câmaras cardíacas, determinou-se varredura pelo STIC e pelo modo renderização foram avaliadas as medidas de oito ângulos do coração fetal, sendo eles: ângulo ápice (ÂA), ângulo base (ÂB), ângulo valva mitral (ÂVM), ângulo valva tricúspide (ÂVT), ângulo ventrículo esquerdo (ÂVE), ângulo ventrículo direito (ÂVD), ângulo átrio esquerdo (ÂAE) e ângulo átrio direito (ÂAD). Para os ângulos foram criados gráficos de dispersão em função da idade gestacional, com ajustes pelo coeficiente de determinação (R²). Para os testes de reprodutibilidade intra e interobservador, utilizou-se o coeficiente de correlação de concordância (CCC). Resultados: A média ± desvio-padrão da idade materna (anos) e a idade gestacional (semanas) foram 31,7 ± 4,9 e 26,3 ± 4,2, respectivamente. Observou-se pouca variação de todos os ângulos do coração fetal pelo STIC renderização com a idade gestacional com R² = 0,01 para ângulo ápice, R² < 0,01 para ângulo base, R² = 0,01 para ângulo valva mitral, R² < 0,01 para ângulo valva tricúspide, R² < 0,01 para ângulo ventrículo esquerdo, R² < 0,01 para ângulo ventrículo direito, R² < 0,01 para ângulo átrio esquerdo, e R² < 0,01 para átrio direito, respectivamente. Observou-se moderada/boa concordância intra e interobservador para a medida dos ângulos internos do coração fetal pelo STIC rendering, com CCC entre 0,74 e 0,93. Conclusão: O coração fetal não apresentou variação significativa de sua geometria ao longo da gestação por meio da ultrassonografia 3D pelo método STIC renderização, com moderada/boa reprodutibilidade intra e interobservador de suas medidas.
- ItemAcesso aberto (Open Access)Avaliação do coração fetal no primeiro trimestre de gestação: influência do comprimento cabeça-nádega e índice de massa corporal materna(Sociedade Brasileira de Cirurgia Cardiovascular, 2013-12-01) Pares, David Baptista da Silva [UNIFESP]; Lima, Angélia Iara Felipe [UNIFESP]; Araujo Júnior, Edward [UNIFESP]; Nardozza, Luciano Marcondes Machado [UNIFESP]; Martins, Wellington P.; Moron, Antonio Fernandes [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade de São Paulo (USP)OBJECTIVE: To evaluate the influence of the crown-rump length and body mass index on sonographic evaluation of the fetal heart using abdominal and vaginal routes in the first trimester of pregnancy. METHODS: We conducted a cross-sectional study with 57 pregnant women between 12-14 weeks (CRL< 84 mm). We evaluated the following fetal cardiac plans using the abdominal and vaginal routes: four-chamber view, right ventricle outflow tract, left ventricle outflow tract and aortic arch. We used the B-mode, color Doppler and four-dimensional ultrasonography (spatio-temporal image correlation). To evaluate the influence of crown-rump length and body mass index in the assessment of fetal cardiac planes, we used the t test unpaired. RESULTS: There were no statistically significant differences in the rates of success and failure between abdominal and vaginal routes in relation to body mass index, however, there was a higher failure rate in vaginal assessment using B mode associated with color Doppler (P<0.01). CONCLUSION: The crown-rump length and body mass index had no interference in fetal cardiac assessment in the first trimester of pregnancy.
- ItemAcesso aberto (Open Access)Débito cardíaco e fração de ejeção fetal por meio do spatio-temporal image correlation (STIC): comparação entre fetos masculinos e femininos(Sociedade Brasileira de Cirurgia Cardiovascular, 2012-06-01) Simioni, Christiane [UNIFESP]; Araujo Júnior, Edward [UNIFESP]; Martins, Wellington P.; Rolo, Liliam Cristine [UNIFESP]; Rocha, Luciane Alves da [UNIFESP]; Nardozza, Luciano Marcondes Machado [UNIFESP]; Moron, Antonio Fernandes [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade de São Paulo (USP)OBJECTIVE: To compare the cardiac output (CO) and ejection fraction (EF) of the heart of male and female fetuses obtained by 3D-ultrasonography using spatio-temporal image correlation (STIC). METHODS: We conducted a cross-sectional study with 216 normal fetuses, between 20 and 34 weeks of gestation, 108 male and 108 female. Ventricular volumes at the end of systole and diastole were obtained by STIC, and the volumetric assessments performed by the virtual organ computer-aided analysis (VOCAL) rotated 30º. To calculate the DC used the formula: DC = stroke volume / fetal heart rate, while for the FE used the formula: EF = stroke volume / end-diastolic volume. The DC (combined male and female) and EF (male and female) were compared using the unpaired t test and ANCOVA. Scatter plots were created with the percentiles 5, 50 and 95. RESULTS: The average of DC combined, DC left, DC right, FE right and FE left, male and female were 240.07 mL/min, 122.67 mL/min, 123.40 mL/min, 72.84%, 67.22%, 270.56 mL/ min, 139.22 mL/min, 131.34 mL/min, 70.73% and 64.76% respectively, without statistical difference (P> 0.05). CONCLUSIONS: The fetal CO and EF obtained by 3Dultrasonography (STIC) showed no significant difference in relation to gender.
- ItemAcesso aberto (Open Access)Determinação da curva de referência das medidas funcionais e dos escores Z no coração de fetos normais por meio do ecodopplercardiograma bidimensional(Universidade Federal de São Paulo (UNIFESP), 2019-02-28) Amorim, Luciane Alves Da Rocha [UNIFESP]; Macedo Junior, Antonio [UNIFESP]; http://lattes.cnpq.br/5590809884662013; http://lattes.cnpq.br/0034994656390110; Universidade Federal de São Paulo (UNIFESP)Introduction: Fetal heart evaluation is comprises of the anatomical and functional examination. Currently, the anatomical study of the fetal heart is well established in the routine of health professionals. However, it is still not consensual which technique is optimal to be applied when evaluating fetal heart function, despite its undeniable importance. In the current literature, there are a tendency to describe the echocardiographic measurements using Z-score equations in pediatric echocardiograms, as they demonstrate greater practicality in establishing the normality or not of the findings. In fetal cardiology, however, the reference values and the Z-score equations are still under development. The objective of this study was to determine the reference values of fetal heart functional measurements at 24 and 34 weeks of gestation and to develop Z-score equations for all measures studied. Method: A single-center, prospective, cross-sectional study with normal fetuses between 24 and 34 weeks of gestation was performed. All pregnant women underwent a comprehensive Doppler echocardiogram with anatomical and functional analysis. Measurements of left and right cardiac output, mitral and tricuspid valves flow, inferior cava vein flow and pulmonary vein flow were made. Shapiro-Wilk test and histogram evaluation were performed on all variables. Linear regression was used to check the relationship between measurements and gestational age. Results: 612 pregnant women with single and normal fetuses were included. We determined the reference values and percentiles of the assessment measures for each gestational age. The variables that were not normally distributed were submitted to logarithmic or square root transformation. It was possible to develop 10 equations of Z score, being the equations of left and right ventricles output dependent on gestational age and the others being independent on gestational age. Conclusion: The present study accumulated a large database, allowing the demonstration of reference values and percentiles, as well as the development of Z score equations to facilitate echocardiographic evaluation of the fetal heart function.
- ItemSomente MetadadadosFetal cardiac function assessed by spatio-temporal image correlation(Springer, 2011-07-01) Simioni, Christiane [UNIFESP]; Machado Nardozza, Luciano Marcondes [UNIFESP]; Araujo Junior, Edward [UNIFESP]; Rolo, Liliam Cristine [UNIFESP]; Terasaka, Ohanna Ana [UNIFESP]; Zamith, Marina Maccagnano [UNIFESP]; Moron, Antonio Fernandes [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Three-dimensional (3D) and four-dimensional (4D) ultrasound have been proposed to be valuable tools for the examination of fetal heart. Spatio-temporal image correlation (STIC) is a technique that adds a time component to 3D ultrasound imaging of the fetal heart, so we can evaluate cardiac structures as a 4D cine sequence containing information of one full cardiac cycle. STIC gives the investigator the opportunity to freeze the displayed cardiac loop in end-diastolic and end-systolic phases. By STIC, 3D measurements of both the left and right ventricle can be used to calculate fetal heart stroke volume, cardiac output and ejection fraction, and expressions of cardiac function. the ultimate goal of STIC technique is to improve fetal cardiac function analysis by decreasing the dependency on operator skills required by two-dimensional ultrasound.In this article, we describe literature practical approach for the examination of the fetal heart function using 4D ultrasound by STIC technique.
- ItemSomente MetadadadosFetal Myocardial Wall Area: Constructing a Reference Range by Means of Spatiotemporal Image Correlation in the Rendering Mode(Karger, 2015-01-01) Bello Barros, Fernanda Silveira [UNIFESP]; Moron, Antonio Fernandes [UNIFESP]; Rolo, Liliam Cristine [UNIFESP]; Rocha, Luciane Alves [UNIFESP]; Martins, Wellington P. [UNIFESP]; Tonni, Gabriele; Machado Nardozza, Luciano Marcondes [UNIFESP]; Araujo Junior, Edward [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Guastalla Civil HospObjective: To establish the reference range of the myocardial wall area in the fetus using three-dimensional ultrasound in the rendering mode. Methods: A prospective, cross-sectional study including 371 singleton, uncomplicated pregnancies at 20 weeks 0 day to 33 weeks 6 days of gestation was carried out. Cardiac volumes were obtained using spatiotemporal image correlation (STIC) at the level of the four-chamber view. the end-diastolic myocardial area of the both ventricles was measured manually. the intraclass correlation coefficient (ICC) was used to assess intra- and interobserver concordance. Results: the mean myocardial area of the fetal right ventricular (RV) wall ranged from 0.86 +/- 0.23 cm(2) at 20 weeks 0 day to 2.75 +/- 0.69 cm(2) at 33 weeks 6 days of gestation. the mean myocardial area of the fetal left ventricular (LV) wall ranged from 0.82 +/- 0.20 cm(2) at 20 weeks 0 day to 2.49 +/- 0.59 cm(2) at 33 weeks 6 days of gestation. in addition, intra- and interobserver concordance for the myocardial area of the RV and LV walls was good, with ICC values of 0.94, 0.95, 0.85, and 0.93, respectively. Conclusions: the reference range for the myocardial area of the RV and LV walls was determined by cardio-STIC in the rendering mode at 20 weeks 0 day to 33 weeks 6 days of gestation, with good concordance between values. (C) 2014 S. Karger AG, Basel.