The Results Of Fetal Echocardiography In A Tertiary Center And Comparison Of Low- And High-Risk Pregnancies For Fetal Congenital Heart Defects

Objective: Fetal echocardiography (FE) is considered for fetal, maternal or hereditary reasons in pregnants with suspect of intrauterine heart disease (IUHD). However, in few studies it was reported that most of the fetuses with IUHD are in the low-risk group (suspicion of IUHD during 2(nd) trimester ultrasound, lack of good vision of the heart, self-referral). Our aim is to examine retrospectively the reasons for referral of pregnants, the results of FE, distribution of pregnants having fetuses with IUHD according to low- and high- risk factors and to evaluate reliability of FE. Methods: Our study group consisted of 1395 fetuses and 1370 pregnants underwent FE between 1999 and 2006. These cases included self-referred women and the pregnants having previous child or family history of cardiac anomaly or referred by obstetricians. The prevalence of IUHDs in low- and high- risk pregnancies was compared by Chi-Square test. Results: The low risk group included 453 patients and the remaining 917 women were in the high- risk group. Intrauterine heart diseases were detected in 152 (10.9%) of 1395 fetuses. The prevalence of IUHDs was 19% in the low- risk group and 7% in the high-risk group. Of the 152 fetuses 56.6% were in the low-risk group and 43.4% were in the high- risk group. The sensitivity of FE for diagnose of IUHDs was 97%, the specificity was 100%. Conclusion: Fetal echocardiography is highly reliable method for diagnosing of IUHDs. The most IUHDs occur in the low- risk group. (Anadolu Kardiyol Derg 2010; 10: 263-9)WoSScopu

Evaluation Of Tissue Doppler Echocardiographic Imaging Findings In Children With Pulmonary Hypertension

Tissue Doppler Imaging has become an important prognostic marker that can be used in follow-up and determination of the prognosis in pulmonary hypertension patients. We compared the Tissue Doppler imaging parameters of 34 patients with pulmonary hypertension and 43 healthy controls. In addition, Brain-Natriuretic Peptide levels, pulmonary artery systolic pressures measured with echocardiography, 6-minute walking tests and New York Heart Association functional classification were compared. Among patients with Eisenmenger syndrome and idiopathic pulmonary hypertension, Tissue Doppler imaging parameters were mostly similar. In patients with New York Heart Association functional class 3, mitral septal annulus E/Ea (p=0.050) and mitral lateral annulus myocardial performance index (p=0.009) were higher than class 2 patients. In patients with higher Brain Natriuretic Peptide level, mitral lateral annulus and tricuspid septal annulus Ea/Aa values were lower (p=0.046 and <0.001 respectively); tricuspid septal annulus E/Ea and interventricular septum myocardial performance index values were higher than in patients with normal Brain-Natriuretic Peptide level (p=0.006). In conclusion tissue Doppler imaging findings were significantly impaired in children with pulmonary hypertension compared to the control group. Findings were similar in patients with idiopathic pulmonary hypertension and Eisenmenger syndrome. Mitral lateral annulus myocardial performance index value may have a prognostic importance due its significant association with poor functional class. Due to the significant associations between mitral lateral annulus, tricuspid septal annulus Ea/Aa, tricuspid septal annulus Ea and E/Aa, interventricular septum-myocardial performance index values and brain natriuretic peptide levels, these parameters may be used in evaluating response to therapy.WoSScopu

Evaluation Of Diagnostic Accuracy Of Portable Echocardiography In Newborns

Objective: Congenital heart disease is the most common life-threatening anomaly in the neonatal period. Screening for this disease with portable echocardiography is crucial to diagnose in the early period, and it has benefits in saving time and decreasing the cost. Portable echocardiography has advantages of rapid access and lower costs and also has advantage that in intensive care units there is no necessity to move patients. With these advantages, it is aimed to compare the sensitivity of portable echocardiography comparing to standard echocardiography. Methods: In this study, the portable echocardiography results of the sequentially enrolled newborns hospitalized in the neonatal departments are revised. Portable echocardiography results were verified with standard echocardiography in 83(43%) female and 111 (57%) male patients. This study was planned as a study on diagnostic accuracy. Results: The gestational periods were between 24 weeks, 3 days and 42 weeks (average 35 weeks 4 weeks 3 days). Birth weights were between 500 and 4850 grams (average 2370 936 grams). The reason that portable echocardiography had been studied was murmur in 113(58.2%) patients, cyanosis in 47(24.2%) patients, prenatal anomaly in 12(6.2%) patients, bradycardia in 12 (6.2%) patients, maternal diabetes in 6(3.1%) patients and respiratory distress in 4(2.1%) patients. Out of 194 patients 8(4.1%) had differences between standard and portable echocardiography. Compared to standard echocardiography, portable echocardiography has the sensitivity values ranged between 99.3-100% and the specificity values ranged between 90.9-100% in diagnosis of specific CHD anomalies. Positive predictive value was between 50-100% whereas negative predictive value was between 97.9-100%. The agreement between results of two tests was determined as very good - kappa 0.886, 95%Cl -0.821-0.951, p<0.0001. Conclusion: It is demonstrated that portable echocardiography has a high sensitivity especially diagnosing major heart defects, and with advantages of rapid access and lower costs it is estimated that increasing usage of portable echocardiography could be beneficial. (Anadolu Kardiyol Derg 2011; 11: 627-32)WoSScopusTr-Dizi

Endovascular stents for treatment of coarctation of the aorta

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