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Development of the Z‐score for the measurement of myocardial thickness by two‐dimensional echocardiography in normal fetuses
Author(s) -
Rocha Luciane Alves,
Zielinsky Paulo,
Nicoloso Luiz Henrique Soares,
Araujo Junior Edward
Publication year - 2021
Publication title -
echocardiography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.404
H-Index - 62
eISSN - 1540-8175
pISSN - 0742-2822
DOI - 10.1111/echo.14953
Subject(s) - interventricular septum , ventricle , medicine , fetus , cardiology , fetal echocardiography , percentile , gestational age , gestation , ventricular outflow tract , lateral wall , pregnancy , prenatal diagnosis , mathematics , biology , genetics , mechanical engineering , statistics , engineering
Background In the current literature, there is a tendency to describe normal values of echocardiographic measurements by means of the Z‐score. In fetal cardiology, these Z‐score equations are still being established. Measurement of myocardial thickness is an important assessment, especially in fetuses of diabetic mothers, because of the risk of developing myocardial hypertrophy secondary to elevated maternal blood glucose levels. Objective To determine the percentiles and to develop the Z‐score equations of right and left ventricular lateral walls and interventricular septum measurements using two‐dimensional echocardiography in normal fetuses between 24 and 34 weeks of gestation. Methods This is a prospective cross‐sectional study that was performed in single fetuses with normal heart from nondiabetic pregnant women. Measurements of the lateral walls of the right and left ventricles and the interventricular septum were made. Results Eight hundred and seventy three pregnant women were included. We determined the percentiles of the measurements for each gestational age. The Z‐score equation was developed for each of the measurements: right ventricular lateral wall measurement [RVLW = x−(−1 + 0.109 * GA)/0.4], left ventricle lateral wall measurement [LVLW = x−(−1.366 + 0.12 * GA)/0.43], and interventricular septum, both at the four‐chamber view [IVS 4ch = (x−(−1.113 + 0.107 * GA)/0.4] and at the left ventricular outflow tract plane [IVS LVOT = (x−(−0.581 + 0.084 * GA)/0.35]. Conclusion The present study allowed the demonstration of the percentiles and the Z‐score equations for each of the measurements studied.