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Anti‐Ro52/SSA antibody‐exposed fetuses with prolonged atrioventricular time intervals show signs of decreased cardiac performance
Author(s) -
Bergman G.,
Eliasson H.,
Bremme K.,
WahrenHerlenius M.,
Sonesson S.E.
Publication year - 2009
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.7343
Subject(s) - medicine , isovolumetric contraction , cardiology , fetus , atrioventricular block , premature atrial contraction , pregnancy , diastole , atrial fibrillation , blood pressure , biology , genetics
Objective To investigate if anti‐Ro/SSA antibody‐exposed fetuses with prolonged atrioventricular (AV) time intervals also have prolongation of the isovolumetric contraction time (ICT). Methods Seventy‐eight anti‐Ro/SSA (including 70 anti‐Ro52) antibody‐exposed fetuses at risk for congenital heart block (CHB) were followed weekly, between 18 and 24 weeks of gestation, with two Doppler echocardiographic methods designed to detect signs of first‐degree AV block. One of these AV time measurements, using hemodynamic events from the mitral valve and aortic outflow as indirect markers of atrial and ventricular depolarization (MV‐Ao), was also used to calculate a time interval representing an early phase of systolic cardiac performance, i.e. the ICT. Two hundred and eighty‐four women with normal pregnancies served as controls for AV time intervals and another 106 were used to establish an ICT reference range. Results Strong positive relationships were found between ICT and MV‐Ao time intervals ( r = 0.91, P < 0.001), as well as between ICT and time intervals obtained from the superior vena cava and aorta ( r = 0.85, P < 0.001). The ICT was estimated to contribute more than 50% of the total AV time prolongation. Abnormal AV time and ICT intervals were only seen in anti‐Ro52 positive pregnancies. Conclusions The ICT is an important contributor to prolongation of AV time intervals. This observation suggests that anti‐Ro52/SSA antibody‐exposed fetal hearts have not only disturbed electrical conduction but also decreased mechanical performance. Moreover, our findings have implications for the interpretation of AV time intervals used for surveillance of fetuses at risk for developing CHB. Copyright © 2009 ISUOG. Published by John Wiley & Sons, Ltd.