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Cardiac time intervals and myocardial performance index for prediction of twin–twin transfusion syndrome

OBJECTIVES: To explore whether intertwin discordance in myocardial performance index (MPI) or cardiac time intervals enables the prediction of twin–twin transfusion syndrome (TTTS) in monochorionic diamniotic (MCDA) pregnancies with amniotic fluid discordance. METHODS: Prospective cohort study of MC...

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Autores principales: Gijtenbeek, Manon, Eschbach, Sanne J., Middeldorp, Johanna M., Klumper, Frans J. C. M., Slaghekke, Femke, Oepkes, Dick, 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/PMC9292435/
https://www.ncbi.nlm.nih.gov/pubmed/34107089
http://dx.doi.org/10.1002/pd.5981
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author Gijtenbeek, Manon
Eschbach, Sanne J.
Middeldorp, Johanna M.
Klumper, Frans J. C. M.
Slaghekke, Femke
Oepkes, Dick
Haak, Monique C.
author_facet Gijtenbeek, Manon
Eschbach, Sanne J.
Middeldorp, Johanna M.
Klumper, Frans J. C. M.
Slaghekke, Femke
Oepkes, Dick
Haak, Monique C.
author_sort Gijtenbeek, Manon
collection PubMed
description OBJECTIVES: To explore whether intertwin discordance in myocardial performance index (MPI) or cardiac time intervals enables the prediction of twin–twin transfusion syndrome (TTTS) in monochorionic diamniotic (MCDA) pregnancies with amniotic fluid discordance. METHODS: Prospective cohort study of MCDA pregnancies with amniotic fluid discordance ≥4 cm. Serial ultrasound examinations consisted of evaluation of amniotic fluid, fetal Dopplers and fetal cardiac function. RESULTS: We included 21 “future‐TTTS” (group I), 18 selective fetal growth restriction (sFGR; group II) and 20 uncomplicated MCDA twin pairs (group III). Group I had a higher intertwin difference in left ventricle (LV) MPI and right ventricle (RV) MPI compared to group II and III. The intertwin difference in global heart relaxation time was significantly higher in group I compared to group III. Future recipient twins had significantly higher contraction times of the global heart and RV and lower relaxation times of the global heart and RV compared to the “expected recipients” in group II and III. CONCLUSION: Intertwin discordance in LV‐MPI and RV‐MPI differentiate between TTTS and MCDA pregnancies with transient discordant amniotic fluid volume. Cardiac time intervals identify future recipient twins. The clinical utility of cardiac time intervals and MPI should be investigated in large prospective studies.
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spelling pubmed-92924352022-07-20 Cardiac time intervals and myocardial performance index for prediction of twin–twin transfusion syndrome Gijtenbeek, Manon Eschbach, Sanne J. Middeldorp, Johanna M. Klumper, Frans J. C. M. Slaghekke, Femke Oepkes, Dick Haak, Monique C. Prenat Diagn Original Articles OBJECTIVES: To explore whether intertwin discordance in myocardial performance index (MPI) or cardiac time intervals enables the prediction of twin–twin transfusion syndrome (TTTS) in monochorionic diamniotic (MCDA) pregnancies with amniotic fluid discordance. METHODS: Prospective cohort study of MCDA pregnancies with amniotic fluid discordance ≥4 cm. Serial ultrasound examinations consisted of evaluation of amniotic fluid, fetal Dopplers and fetal cardiac function. RESULTS: We included 21 “future‐TTTS” (group I), 18 selective fetal growth restriction (sFGR; group II) and 20 uncomplicated MCDA twin pairs (group III). Group I had a higher intertwin difference in left ventricle (LV) MPI and right ventricle (RV) MPI compared to group II and III. The intertwin difference in global heart relaxation time was significantly higher in group I compared to group III. Future recipient twins had significantly higher contraction times of the global heart and RV and lower relaxation times of the global heart and RV compared to the “expected recipients” in group II and III. CONCLUSION: Intertwin discordance in LV‐MPI and RV‐MPI differentiate between TTTS and MCDA pregnancies with transient discordant amniotic fluid volume. Cardiac time intervals identify future recipient twins. The clinical utility of cardiac time intervals and MPI should be investigated in large prospective studies. John Wiley and Sons Inc. 2021-06-17 2021-11 /pmc/articles/PMC9292435/ /pubmed/34107089 http://dx.doi.org/10.1002/pd.5981 Text en © 2021 The Authors. Prenatal Diagnosis published by John Wiley & Sons Ltd. 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 Articles
Gijtenbeek, Manon
Eschbach, Sanne J.
Middeldorp, Johanna M.
Klumper, Frans J. C. M.
Slaghekke, Femke
Oepkes, Dick
Haak, Monique C.
Cardiac time intervals and myocardial performance index for prediction of twin–twin transfusion syndrome
title Cardiac time intervals and myocardial performance index for prediction of twin–twin transfusion syndrome
title_full Cardiac time intervals and myocardial performance index for prediction of twin–twin transfusion syndrome
title_fullStr Cardiac time intervals and myocardial performance index for prediction of twin–twin transfusion syndrome
title_full_unstemmed Cardiac time intervals and myocardial performance index for prediction of twin–twin transfusion syndrome
title_short Cardiac time intervals and myocardial performance index for prediction of twin–twin transfusion syndrome
title_sort cardiac time intervals and myocardial performance index for prediction of twin–twin transfusion syndrome
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9292435/
https://www.ncbi.nlm.nih.gov/pubmed/34107089
http://dx.doi.org/10.1002/pd.5981
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