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Assessment of human fetal cardiac autonomic nervous system development using color tissue Doppler imaging

OBJECTIVES: Functional development of the fetal cardiac autonomic nervous system (cANS) plays a key role in fetal maturation and can be assessed through fetal heart rate variability (fHRV)‐analysis, with each HRV parameter representing different aspects of cANS activity. Current available techniques...

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Autores principales: Zwanenburg, Fleur, Jongbloed, Monique R. M., van Geloven, Nan, ten Harkel, Arend D. J., van Lith, Jan M. M., Haak, Monique C.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8252470/
https://www.ncbi.nlm.nih.gov/pubmed/34018638
http://dx.doi.org/10.1111/echo.15094
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author Zwanenburg, Fleur
Jongbloed, Monique R. M.
van Geloven, Nan
ten Harkel, Arend D. J.
van Lith, Jan M. M.
Haak, Monique C.
author_facet Zwanenburg, Fleur
Jongbloed, Monique R. M.
van Geloven, Nan
ten Harkel, Arend D. J.
van Lith, Jan M. M.
Haak, Monique C.
author_sort Zwanenburg, Fleur
collection PubMed
description OBJECTIVES: Functional development of the fetal cardiac autonomic nervous system (cANS) plays a key role in fetal maturation and can be assessed through fetal heart rate variability (fHRV)‐analysis, with each HRV parameter representing different aspects of cANS activity. Current available techniques, however, are unable to assess the fHRV parameters accurately throughout the whole pregnancy. This study aims to test the feasibility of color tissue Doppler imaging (cTDI) as a new ultrasound technique for HRV analysis. Secondly, we explored time trends of fHRV parameters using this technique. METHODS: 18 healthy singleton fetuses were examined sequentially every 8 weeks from 10 weeks GA onwards. From each examination, 3 cTDI recordings of the four‐chamber view of 10 seconds were retrieved to determine accurate beat‐to‐beat intervals. The fHRV parameters SDNN, RMSSD, SDNN/RMSSD, and pNN10, each representing different functional aspects of the cANS, were measured, and time trends during pregnancy were explored using spline functions within a linear mixed‐effects model. RESULTS: In total, 77% (95% Cl 66–87%) of examinations were feasible for fHRV analysis from the first trimester onwards, which is a great improvement compared to other techniques. The technique is able to determine different maturation rates of the fHRV parameters, showing that cANS function, presumably parasympathetic activity, establishes around 20 weeks GA and matures rapidly until 30 weeks GA. CONCLUSIONS: This is the first study able to assess cANS function through fHRV analysis from the first trimester onwards. The use of cTDI to determine beat‐to‐beat intervals seems feasible in just 3 clips of 10 seconds, which holds promise for future clinical use in assessing fetal well‐being.
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spelling pubmed-82524702021-07-07 Assessment of human fetal cardiac autonomic nervous system development using color tissue Doppler imaging Zwanenburg, Fleur Jongbloed, Monique R. M. van Geloven, Nan ten Harkel, Arend D. J. van Lith, Jan M. M. Haak, Monique C. Echocardiography Original Investigations OBJECTIVES: Functional development of the fetal cardiac autonomic nervous system (cANS) plays a key role in fetal maturation and can be assessed through fetal heart rate variability (fHRV)‐analysis, with each HRV parameter representing different aspects of cANS activity. Current available techniques, however, are unable to assess the fHRV parameters accurately throughout the whole pregnancy. This study aims to test the feasibility of color tissue Doppler imaging (cTDI) as a new ultrasound technique for HRV analysis. Secondly, we explored time trends of fHRV parameters using this technique. METHODS: 18 healthy singleton fetuses were examined sequentially every 8 weeks from 10 weeks GA onwards. From each examination, 3 cTDI recordings of the four‐chamber view of 10 seconds were retrieved to determine accurate beat‐to‐beat intervals. The fHRV parameters SDNN, RMSSD, SDNN/RMSSD, and pNN10, each representing different functional aspects of the cANS, were measured, and time trends during pregnancy were explored using spline functions within a linear mixed‐effects model. RESULTS: In total, 77% (95% Cl 66–87%) of examinations were feasible for fHRV analysis from the first trimester onwards, which is a great improvement compared to other techniques. The technique is able to determine different maturation rates of the fHRV parameters, showing that cANS function, presumably parasympathetic activity, establishes around 20 weeks GA and matures rapidly until 30 weeks GA. CONCLUSIONS: This is the first study able to assess cANS function through fHRV analysis from the first trimester onwards. The use of cTDI to determine beat‐to‐beat intervals seems feasible in just 3 clips of 10 seconds, which holds promise for future clinical use in assessing fetal well‐being. John Wiley and Sons Inc. 2021-05-21 2021-06 /pmc/articles/PMC8252470/ /pubmed/34018638 http://dx.doi.org/10.1111/echo.15094 Text en © 2021 The Authors. Echocardiography published by Wiley Periodicals LLC https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Original Investigations
Zwanenburg, Fleur
Jongbloed, Monique R. M.
van Geloven, Nan
ten Harkel, Arend D. J.
van Lith, Jan M. M.
Haak, Monique C.
Assessment of human fetal cardiac autonomic nervous system development using color tissue Doppler imaging
title Assessment of human fetal cardiac autonomic nervous system development using color tissue Doppler imaging
title_full Assessment of human fetal cardiac autonomic nervous system development using color tissue Doppler imaging
title_fullStr Assessment of human fetal cardiac autonomic nervous system development using color tissue Doppler imaging
title_full_unstemmed Assessment of human fetal cardiac autonomic nervous system development using color tissue Doppler imaging
title_short Assessment of human fetal cardiac autonomic nervous system development using color tissue Doppler imaging
title_sort assessment of human fetal cardiac autonomic nervous system development using color tissue doppler imaging
topic Original Investigations
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8252470/
https://www.ncbi.nlm.nih.gov/pubmed/34018638
http://dx.doi.org/10.1111/echo.15094
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