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P 07.13: Contributions of fetal gestation, estimated weight and heart rate to myocardial performance index ( MPI ) variation
Author(s) -
Henry A.,
Pakmehr S.,
Meriki N.,
Welsh A.W.
Publication year - 2014
Publication title -
ultrasound in obstetrics and gynecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.202
H-Index - 141
eISSN - 1469-0705
pISSN - 0960-7692
DOI - 10.1002/uog.14129
Subject(s) - medicine , singleton , gestational age , cohort , fetus , obstetrics , population , gestation , pregnancy , genetics , environmental health , biology
ObjectivesTo examine the contributions of gestational age (GA), estimated fetal weight (EFW) and fetal heart rate (FHR) to observed variability of left and right myocardial performance index (LMI and RMPI) values in a cohort of both uncomplicated and growth-restricted (IUGR) singleton pregnancies.MethodsMPI values were correlated with EFW, GA and FHR at time of study for singleton fetuses from both reference interval and pathological cohorts. Linear regression was used to examine proportion of MPI variability potentially explained by EFW, GA and FHR.ResultsAs shown in the table, in the uncomplicated LMPI cohort (258 studies of 151 fetuses) EFW and GA both showed weak but significant positive correlation with LMPI, with GA and EFW accounting for 6.0% and 4.0% of total variation in LMPI respectively. FHR was significantly correlated with GA and EFW but not LMPI. GA and EFW were as expected highly correlated (R = 0.966). The smaller RMPI cohort (n = 86) did not demonstrate significant correlation between RMPI and EFW, GA, or FHR. In the IUGR cohort (16 studies, 13 fetuses), GA and EFW were negatively correlated with both LMPI (NS) and RMPI (p = 0.045 and 0.046), but FHR was moderately positively correlated with both LMPI (p = 0.02) and RMPI (p = 0.002), accounting for 31.6% and 52.1% of LMPI and RMPI variation respectively.ConclusionsIn an uncomplicated singleton population, GA, EFW and FHR are only weakly correlated with MPI values and account for <10% of observed MPI variability. In IUGR fetuses, both LMPI and RMPI were moderately positively correlated with FHR, which is possibly secondary to the fetus using an increased heart rate to increase cardiac output in conditions of increased cardiac strain