Premium
Cerebral blood flow dynamic in foetuses with hypoplastic left heart syndrome: Incremental value of the first segment of the anterior cerebral artery over the middle cerebral artery?
Author(s) -
Liu Yushan,
Zeng Shi,
Tan Ya,
Zhou Jiawei,
Zhao Baihua
Publication year - 2020
Publication title -
prenatal diagnosis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.956
H-Index - 97
eISSN - 1097-0223
pISSN - 0197-3851
DOI - 10.1002/pd.5564
Subject(s) - medicine , hypoplastic left heart syndrome , middle cerebral artery , cardiology , blood flow , anterior cerebral artery , fetus , gestational age , cerebral blood flow , hypoplasia , cerebral arteries , anatomy , pregnancy , heart disease , ischemia , biology , genetics
Objective To investigate the blood flow Doppler parameters of the anterior cerebral artery (ACA) in foetuses with hypoplastic left heart syndrome (HLHS). Methods Doppler parameters (peak systolic velocity [PSV], end‐diastolic velocity [EDV], time‐averaged maximum velocity [TAMXV] and pulsatility index [PI]) and biometric parameters were measured in two anatomical segments of the ACA (S1 and S2) and in the middle cerebral artery (MCA) in 35 HLHS foetuses and 73 gestational age‐matched normal foetuses. Correlations between the cerebral artery PIs and head circumference (HC) were assessed. Results Both EDV and TAMXV of the ACA and MCA in the HLHS group were significantly higher than in the normal group ( P < .05). The PI of the ACA and MCA in the HLHS group were significantly lower than in the normal group ( P < .05). ACAS1PI and ACAS2PI in the HLHS foetuses with retrograde blood flow in the aortic isthmus (AoI) were significantly lower than those of HLHS foetuses without retrograde blood flow in the AoI ( P < .05). ACAS2PI was significantly lower than ACAS1PI in the HLHS foetuses with retrograde blood flow in the AoI ( P = .047). The abnormal rates of ACAS1 and ACAS2 were significantly higher than that of the MCA ( P < .05) in the HLHS group. The HC and biparietal diameter were significantly lower in the HLHS group than in the control group ( P < .05). HC was correlated with the PIs of ACAS1, ACAS2 and the MCA in the HLHS group ( P < .05). Conclusion A redistribution of foetal cerebral blood flow appeared in HLHS, and the measurement of ACA PI might provide early information on brain hypoxia.