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LIBRIS Formathandbok  (Information om MARC21)
FältnamnIndikatorerMetadata
00005129naa a2200361 4500
001oai:lup.lub.lu.se:b74b5712-1f80-4878-af2b-b31b89e555a4
003SwePub
008231205s2023 | |||||||||||000 ||eng|
0247 a https://lup.lub.lu.se/record/b74b5712-1f80-4878-af2b-b31b89e555a42 URI
0247 a https://doi.org/10.3389/fcvm.2023.12853912 DOI
040 a (SwePub)lu
041 a engb eng
042 9 SwePub
072 7a art2 swepub-publicationtype
072 7a ref2 swepub-contenttype
1001 a Fricke, Katrinu Lund University,Lunds universitet,Barnkardiologi,Forskargrupper vid Lunds universitet,Children cardiology,Lund University Research Groups,Skåne University Hospital4 aut0 (Swepub:lu)ka4323fr
2451 0a Fetal cardiac magnetic resonance imaging of the descending aorta in suspected left-sided cardiac obstructions
264 1c 2023
520 a Background: Severe left-sided cardiac obstructions are associated with high morbidity and mortality if not detected in time. The correct prenatal diagnosis of coarctation of the aorta (CoA) is difficult. Fetal cardiac magnetic resonance imaging (CMR) may improve the prenatal diagnosis of complex congenital heart defects. Flow measurements in the ascending aorta could aid in predicting postnatal CoA, but its accurate visualization is challenging.Objectives: To compare the flow in the descending aorta (DAo) and umbilical vein (UV) in fetuses with suspected left-sided cardiac obstructions with and without the need for postnatal intervention and healthy controls by fetal phase-contrast CMR flow. A second objective was to determine if adding fetal CMR to echocardiography (echo) improves the fetal CoA diagnosis.Methods: Prospective fetal CMR phase-contrast flow in the DAo and UV and echo studies were conducted between 2017 and 2022.Results: A total of 46 fetuses with suspected left-sided cardiac obstructions [11 hypoplastic left heart syndrome (HLHS), five critical aortic stenosis (cAS), and 30 CoA] and five controls were included. Neonatal interventions for left-sided cardiac obstructions (n = 23) or comfort care (n = 1 with HLHS) were pursued in all 16 fetuses with suspected HLHS or cAS and in eight (27%) fetuses with true CoA. DAo or UV flow was not different in fetuses with and without need of intervention. However, DAo and UV flows were lower in fetuses with either retrograde isthmic systolic flow [DAo flow 253 (72) vs. 261 (97) ml/kg/min, p = 0.035; UV flow 113 (75) vs. 161 (81) ml/kg/min, p = 0.04] or with suspected CoA and restrictive atrial septum [DAo flow 200 (71) vs. 268 (94) ml/kg/min, p = 0.04; UV flow 89 vs. 159 (76) ml/kg/min, p = 0.04] as well as in those without these changes. Adding fetal CMR to fetal echo predictors for postnatal CoA did not improve the diagnosis of CoA.Conclusion: Fetal CMR-derived DAo and UV flow measurements do not improve the prenatal diagnosis of left-sided cardiac obstructions, but they could be important in identifying fetuses with a more severe decrease in blood flow across the left side of the heart. The physiological explanation may be a markedly decreased left ventricular cardiac output with subsequent retrograde systolic isthmic flow and decreased total DAo flow.
650 7a MEDICIN OCH HÄLSOVETENSKAPx Klinisk medicinx Radiologi och bildbehandling0 (SwePub)302082 hsv//swe
650 7a MEDICAL AND HEALTH SCIENCESx Clinical Medicinex Radiology, Nuclear Medicine and Medical Imaging0 (SwePub)302082 hsv//eng
650 7a MEDICIN OCH HÄLSOVETENSKAPx Klinisk medicinx Kardiologi0 (SwePub)302062 hsv//swe
650 7a MEDICAL AND HEALTH SCIENCESx Clinical Medicinex Cardiac and Cardiovascular Systems0 (SwePub)302062 hsv//eng
7001 a Ryd, Danielu Lund University,Lunds universitet,Hjärt-MR-gruppen i Lund,Forskargrupper vid Lunds universitet,Lund Cardiac MR Group,Lund University Research Groups,Skåne University Hospital4 aut0 (Swepub:lu)da6014sa
7001 a Weismann, Constance G.u Lund University,Lunds universitet,Barnkardiologi,Forskargrupper vid Lunds universitet,Children cardiology,Lund University Research Groups,Ludwig-Maximilian University of Munich,Skåne University Hospital4 aut0 (Swepub:lu)co7116we
7001 a Hanséus, Katarinau Skåne University Hospital4 aut0 (Swepub:lu)pedi-kha
7001 a Hedström, Eriku Lund University,Lunds universitet,Hjärt-MR-gruppen i Lund,Forskargrupper vid Lunds universitet,Pediatrisk radiologi,Lund Cardiac MR Group,Lund University Research Groups,Skåne University Hospital4 aut0 (Swepub:lu)klin-ehe
7001 a Liuba, Petruu Lund University,Lunds universitet,Barnkardiologi,Forskargrupper vid Lunds universitet,Children cardiology,Lund University Research Groups,Skåne University Hospital4 aut0 (Swepub:lu)pedi-pli
7102 a Barnkardiologib Forskargrupper vid Lunds universitet4 org
7730 t Frontiers in Cardiovascular Medicineg 10, s. 01-10q 10<01-10x 2297-055X
8564 u http://dx.doi.org/10.3389/fcvm.2023.1285391x freey FULLTEXT
8564 8u https://lup.lub.lu.se/record/b74b5712-1f80-4878-af2b-b31b89e555a4
8564 8u https://doi.org/10.3389/fcvm.2023.1285391

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