Tissue Doppler echocardiographic markers of cardiac dysfunction in small-for-gestational age fetuses.

Abstract

The objective of the study was to evaluate echocardiographic markers of cardiac dysfunction in small-for-gestational age (SGA) fetuses with normal umbilical artery Doppler. Cardiac function was evaluated in 58 SGA (mean gestational age, 38 weeks) and 58 gestational-age matched normally grown fetuses by conventional echocardiography (peak early [E] and late [A] ratios and myocardial performance index [MPI]), and tissue Doppler imaging (TDI) (annular peak velocities and MPI'). With conventional echocardiography, SGA fetuses had a nonsignificant trend to increased E/A ratios and left MPI compared with controls. TDI demonstrated that SGA fetuses had significantly lower right E' and A' peak velocities and higher MPI' values. These findings further support that a proportion of SGA fetuses have true late-onset intrauterine growth restriction, which is associated with subclinical cardiac dysfunction, as previously described for early-onset intrauterine growth restriction.