Third Trimester Fetal Cardiac Blood Flow and Cardiac Outcomes in School‐Age Children Assessed By Magnetic Resonance Imaging
Background An adverse fetal environment leads to fetal hemodynamic adaptations with cardiac flow alterations that may subsequently affect cardiac development. We examined the associations of third trimester placental and fetal cardiac hemodynamics with cardiac outcomes in school‐age children. Method...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2019-08-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.119.012821 |
| _version_ | 1811332629960589312 |
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| author | Liza Toemen Gavro Jelic Marjolein N. Kooijman Romy Gaillard Willem A. Helbing Aad van der Lugt Arno A. W. Roest Irwin K. M. Reiss Eric A. P. Steegers Vincent W. V. Jaddoe |
| author_facet | Liza Toemen Gavro Jelic Marjolein N. Kooijman Romy Gaillard Willem A. Helbing Aad van der Lugt Arno A. W. Roest Irwin K. M. Reiss Eric A. P. Steegers Vincent W. V. Jaddoe |
| author_sort | Liza Toemen |
| collection | DOAJ |
| description | Background An adverse fetal environment leads to fetal hemodynamic adaptations with cardiac flow alterations that may subsequently affect cardiac development. We examined the associations of third trimester placental and fetal cardiac hemodynamics with cardiac outcomes in school‐age children. Methods and Results We performed a population‐based prospective cohort study among 547 mothers and their children. At a gestational age of 30.4 (95% range 28.4–32.7) weeks, we measured umbilical and cerebral artery resistance, cardiac output, and tricuspid and mitral E/A waves with Doppler. At the median age of 10.0 years (95% range 9.4–11.7) we measured cardiac outcomes with cardiac magnetic resonance imaging. Cardiac outcomes included right ventricular end‐diastolic volume) and right ventricular ejection fraction, left ventricular end diastolic volume and left ventricular ejection fraction, left ventricular mass, and left ventricular mass‐to‐volume ratio as left ventricular mass/left ventricular end diastolic volume. Higher third‐trimester umbilical artery resistance was associated with higher childhood right ventricular ejection fraction (P value <0.05), but not with other cardiac outcomes. The third‐trimester umbilical artery‐cerebral artery pulsatility index ratio was not associated with childhood cardiac outcomes. Higher third‐trimester fetal left cardiac output was associated with lower childhood left ventricular ejection fraction and higher left ventricular mass‐to‐volume ratio (P value <0.05). Third‐trimester fetal right cardiac output was not associated with childhood cardiac outcomes. A higher third‐trimester fetal tricuspid valve E/A ratio was associated with higher childhood right ventricular ejection fraction (P value <0.05). Conclusions Our findings suggest that fetal cardiac fetal blood flow redistribution may have long‐term effects on cardiac structure and function. These results should be considered as hypothesis generating and need further replication. |
| first_indexed | 2024-04-13T16:39:50Z |
| format | Article |
| id | doaj.art-40f5d6b26132472fbaad1ec06d0109a5 |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-04-13T16:39:50Z |
| publishDate | 2019-08-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-40f5d6b26132472fbaad1ec06d0109a52022-12-22T02:39:17ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802019-08-0181610.1161/JAHA.119.012821Third Trimester Fetal Cardiac Blood Flow and Cardiac Outcomes in School‐Age Children Assessed By Magnetic Resonance ImagingLiza Toemen0Gavro Jelic1Marjolein N. Kooijman2Romy Gaillard3Willem A. Helbing4Aad van der Lugt5Arno A. W. Roest6Irwin K. M. Reiss7Eric A. P. Steegers8Vincent W. V. Jaddoe9Generation R Study Group Erasmus University Medical Center Rotterdam the NetherlandsGeneration R Study Group Erasmus University Medical Center Rotterdam the NetherlandsGeneration R Study Group Erasmus University Medical Center Rotterdam the NetherlandsGeneration R Study Group Erasmus University Medical Center Rotterdam the NetherlandsDepartment of Pediatrics Erasmus University Medical Center Rotterdam the NetherlandsDepartment of Radiology Erasmus University Medical Center Rotterdam The NetherlandsDepartment of Pediatrics Leiden University Medical Center Leiden The NetherlandsDepartment of Pediatrics Erasmus University Medical Center Rotterdam the NetherlandsDepartment of Obstetrics & Gynecology Erasmus University Medical Center Rotterdam The NetherlandsGeneration R Study Group Erasmus University Medical Center Rotterdam the NetherlandsBackground An adverse fetal environment leads to fetal hemodynamic adaptations with cardiac flow alterations that may subsequently affect cardiac development. We examined the associations of third trimester placental and fetal cardiac hemodynamics with cardiac outcomes in school‐age children. Methods and Results We performed a population‐based prospective cohort study among 547 mothers and their children. At a gestational age of 30.4 (95% range 28.4–32.7) weeks, we measured umbilical and cerebral artery resistance, cardiac output, and tricuspid and mitral E/A waves with Doppler. At the median age of 10.0 years (95% range 9.4–11.7) we measured cardiac outcomes with cardiac magnetic resonance imaging. Cardiac outcomes included right ventricular end‐diastolic volume) and right ventricular ejection fraction, left ventricular end diastolic volume and left ventricular ejection fraction, left ventricular mass, and left ventricular mass‐to‐volume ratio as left ventricular mass/left ventricular end diastolic volume. Higher third‐trimester umbilical artery resistance was associated with higher childhood right ventricular ejection fraction (P value <0.05), but not with other cardiac outcomes. The third‐trimester umbilical artery‐cerebral artery pulsatility index ratio was not associated with childhood cardiac outcomes. Higher third‐trimester fetal left cardiac output was associated with lower childhood left ventricular ejection fraction and higher left ventricular mass‐to‐volume ratio (P value <0.05). Third‐trimester fetal right cardiac output was not associated with childhood cardiac outcomes. A higher third‐trimester fetal tricuspid valve E/A ratio was associated with higher childhood right ventricular ejection fraction (P value <0.05). Conclusions Our findings suggest that fetal cardiac fetal blood flow redistribution may have long‐term effects on cardiac structure and function. These results should be considered as hypothesis generating and need further replication.https://www.ahajournals.org/doi/10.1161/JAHA.119.012821cardiac developmentcardiac magnetic resonance imagingchildhoodfetal programmingplacental hemodynamics |
| spellingShingle | Liza Toemen Gavro Jelic Marjolein N. Kooijman Romy Gaillard Willem A. Helbing Aad van der Lugt Arno A. W. Roest Irwin K. M. Reiss Eric A. P. Steegers Vincent W. V. Jaddoe Third Trimester Fetal Cardiac Blood Flow and Cardiac Outcomes in School‐Age Children Assessed By Magnetic Resonance Imaging Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease cardiac development cardiac magnetic resonance imaging childhood fetal programming placental hemodynamics |
| title | Third Trimester Fetal Cardiac Blood Flow and Cardiac Outcomes in School‐Age Children Assessed By Magnetic Resonance Imaging |
| title_full | Third Trimester Fetal Cardiac Blood Flow and Cardiac Outcomes in School‐Age Children Assessed By Magnetic Resonance Imaging |
| title_fullStr | Third Trimester Fetal Cardiac Blood Flow and Cardiac Outcomes in School‐Age Children Assessed By Magnetic Resonance Imaging |
| title_full_unstemmed | Third Trimester Fetal Cardiac Blood Flow and Cardiac Outcomes in School‐Age Children Assessed By Magnetic Resonance Imaging |
| title_short | Third Trimester Fetal Cardiac Blood Flow and Cardiac Outcomes in School‐Age Children Assessed By Magnetic Resonance Imaging |
| title_sort | third trimester fetal cardiac blood flow and cardiac outcomes in school age children assessed by magnetic resonance imaging |
| topic | cardiac development cardiac magnetic resonance imaging childhood fetal programming placental hemodynamics |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.119.012821 |
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