Fetal Cardiology Featured Articles of May 2017

Fetal Cardiology Reviews of May 2017 Manuscripts

 

Usefulness of the Prenatal Echocardiogram in Fetuses with Isolated Transposition of the Great Arteries to Predict the Need for Balloon Atrial Septostomy.

Vigneswaran TV, Zidere V, Miller OI, Simpson JM, Sharland GK.

Am J Cardiol. 2017 May 1;119(9):1463-1467. doi: 10.1016/j.amjcard.2017.01.017. Epub 2017 Feb 9.

PMID: 28283176

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Take Home Points:

 

  • Following prenatal diagnosis of isolated d-transposition (D-TGA) of great arteries, prediction of fetuses requiring postnatal balloon atrial septostomy (BAS) remains challenging.
  • Restrictive atrial septum associated hypoxia continues to be a significant cause of morbidity in patients with a restrictive atrial septum.
  • To evaluate the usefulness of prenatal echocardiogram in predicting need for postnatal BAS, third trimester fetal echocardiographic characteristics including arterial valves, arterial duct, total septal length (TSL), and foramen ovale (FO) length were made, in addition to a subjective assessment of the atrial septum were evaluated in the study.
  • The foramen ovale (FO): total septal length (TSL) <0.5 had 99% sensitivity in identifying fetuses requiring balloon atrial septostomy in isolated D-TGA. FO: TSL was significantly smaller in those who required a BAS with good predictive value (area under the receiver operating characteristics curve: 0.80).
  • Restrictive movement of the atrial septum and smaller ovale length (6.8 ±2.8 mm vs. 8.8±1.7mm) is associated with higher likelihood of postnatal BAS.
  • Hypermobile and aneurysmal atrial septum was not associated with higher likelihood of postnatal BAS.

 

Shaji Menon Portrait 12.15.14Commentary from Dr. Shaji Menon (Salt Lake City), section editor of Pediatric Cardiology Journal Watch: This retrospective study from London, third trimester fetal echocardiograms of 40 cases of isolated TGA when compared to gestation matched control.  The factors evaluated in the prenatal echocardiogram included arterial valves, arterial duct, total septal length (TSL), and foramen ovale (FO) length were made, in addition to a subjective assessment of the atrial septum.  In emergency postnatal BAS was required and 12 out of 40 cases.  All 3 cases with limited movement of the atrial septum required emergency balloon atrial septostomy. The FO length in normal fetuses was not significantly different from those with TGA who did not require an emergency BAS but was significantly smaller in fetuses with TGA who required an emergency BAS (p < 0.01). The FO: TSL was significantly smaller in those who required an emergency BAS with good predictive value (area under the receiver operating characteristics curve: 0.80). The sensitivity for FO: TSL <0.5 was 99%. Hypermobile atrial septum was not associated with emergency BAS.

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First-Trimester Fetal Echocardiography: Identification of Cardiac Structures for Screening from 6 to 13 Weeks’ Gestational Age.

Hutchinson D, McBrien A, Howley L, Yamamoto Y, Sekar P, Motan T, Jain V, Savard W, Hornberger LK.

J Am Soc Echocardiogr. 2017 May 13. pii: S0894-7317(17)30217-1. doi: 10.1016/j.echo.2017.03.017. [Epub ahead of print]

PMID: 28511860

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Take Home Points:

 

  • Development of the fetal heart is generally complete by 7-8 weeks of gestation.
  • With advances in ultrasound technology fetal echocardiograms performed early in the gestation, 12-16 weeks, has been shown to be effective in identifying structural heart disease.
  • This study shows that very early fetal echocardiogram, as early as 8 weeks can be used to assess cardiac structure and color Doppler imaging enhances the diagnostic yield of fetal echocardiograms.
  • The best time for a complete early fetal echocardiogram excluding pulmonary veins appear to be around 11 weeks of gestation.

 

Commentary from Dr. Shaji Menon (Salt Lake City), section editor of Pediatric Cardiology Journal Watch: This is a single central prospective study evaluating the ability of fetal echocardiogram to visualize cardiac structure in the first trimester from as early as 6 weeks of gestation.  The study included a total of 261 early fetal echocardiographic examinations in 202 individual pregnancies, including 166 singletons, 33 sets of twins, and three sets of triplets.  All subjects underwent transabdominal scan.  Transvaginal scanning was used in addition to transabdominal scan in subjects less than 11 weeks of gestation.  Four chambers could be identified in 52% of patients in the eighth week (n = 12 of 23), improving to 80% (n = 36 of 45) in the 10th week and 98% (n = 57 of 58) by the 11th week. The inferior vena cava was seen by 2D imaging in only 4% (n = 1 of 23) in the eighth week, increasing to 13% (n = 6 of 45) by the 10th week and 80% (n = 25 of 31) by the 13th week.  Pulmonary veins could be assessed only after the 11th week.  Outflow tracts could be visualized by 2D imaging in 16% from 8-10 week and an 80% from 11-14 weeks.  Color Doppler imaging significantly improves the visualization of outflow tracts.

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Fetal cardiology May 2017

 

  1. Fetal Cardiac US: Techniques and Normal Anatomy Correlated with Adult CT and MR Imaging.

Patel N, Narasimhan E, Kennedy A.

Radiographics. 2017 Jun 2:160126. doi: 10.1148/rg.2017160126. [Epub ahead of print]

PMID: 28574808

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  1. Phenotyping cardiac and structural birth defects in fetal and newborn mice.

Liu X, Kim AJ, Reynolds W, Wu Y, Lo CW.

Birth Defects Res. 2017 Jun 1;109(10):778-790. doi: 10.1002/bdr2.1048. Epub 2017 May 22. Review.

PMID: 28544620

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  1. A Targeted, Next-Generation Genetic Sequencing Study on Tetralogy of Fallot, Combined With Cleft Lip and Palate.

Liu L, Bu H, Yang Y, Tan Z, Zhang F, Hu S, Zhao T.

J Craniofac Surg. 2017 Jun;28(4):e351-e355. doi: 10.1097/SCS.0000000000003598.

PMID: 28230599

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  1. Role of HDLive in Imaging the Fetal Heart.

Lakshmy SR, Jain B, Rose N.

J Ultrasound Med. 2017 Jun;36(6):1267-1278. doi: 10.7863/ultra.16.05071. Epub 2017 Mar 11.

PMID: 28295440

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  1. Developmental Changes in Aortic Mechanical Properties in Normal Fetuses and Fetuses with Cardiovascular Disease.

Taketazu M, Sugimoto M, Saiki H, Ishido H, Masutani S, Senzaki H.

Pediatr Neonatol. 2017 Jun;58(3):245-250. doi: 10.1016/j.pedneo.2016.05.004. Epub 2016 Sep 28.

PMID: 27816335 Free Article

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  1. Neonatal outcomes in fetuses with cardiac anomalies and the impact of delivery route.

Parikh LI, Grantz KL, Iqbal SN, Huang CC, Landy HJ, Fries MH, Reddy UM.

Am J Obstet Gynecol. 2017 May 31. pii: S0002-9378(17)30678-6. doi: 10.1016/j.ajog.2017.05.049. [Epub ahead of print]

PMID: 28578168

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  1. The complex genetics of hypoplastic left heart syndrome.

Liu X, Yagi H, Saeed S, Bais AS, Gabriel GC, Chen Z, Peterson KA, Li Y, Schwartz MC, Reynolds WT, Saydmohammed M, Gibbs B, Wu Y, Devine W, Chatterjee B, Klena NT, Kostka D, de Mesy Bentley KL, Ganapathiraju MK, Dexheimer P, Leatherbury L, Khalifa O, Bhagat A, Zahid M, Pu W, Watkins S, Grossfeld P, Murray SA, Porter GA Jr, Tsang M, Martin LJ, Benson DW, Aronow BJ, Lo CW.

Nat Genet. 2017 May 22. doi: 10.1038/ng.3870. [Epub ahead of print]

PMID: 28530678

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  1. Association Analysis of Nonsyndromic Congenital Heart Disease and Tag Single-Nucleotide Polymorphisms of TBX20 and Genes in the Ras-MAPK Pathway.

Luo Z, Shen Y, Chen W, Ma X, Liu L, Huang X, Yang Z, Sun H.

Genet Test Mol Biomarkers. 2017 May 19. doi: 10.1089/gtmb.2016.0369. [Epub ahead of print]

PMID: 28525297

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  1. Epidemiology of Live Born Infants with Nonimmune Hydrops Fetalis-Insights from a Population-Based Dataset.

Steurer MA, Peyvandi S, Baer RJ, MacKenzie T, Li BC, Norton ME, Jelliffe-Pawlowski LL, Moon-Grady AJ.

J Pediatr. 2017 May 19. pii: S0022-3476(17)30508-5. doi: 10.1016/j.jpeds.2017.04.025. [Epub ahead of print]

PMID: 28533037

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  1. Induced pluripotent stem cell modelling of HLHS underlines the contribution of dysfunctional NOTCH signalling to impaired cardiogenesis.

Yang C, Xu Y, Yu M, Lee D, Alharti S, Hellen N, Ahmad Shaik N, Banaganapalli B, Sheikh HAM, Ramu E, Przyborski S, Tenin G, Williams S, O’Sullivan J, Al-Radi OO, Atta J, Harding SE, Keavney B, Lako M, Armstrong L.

Hum Mol Genet. 2017 May 17. doi: 10.1093/hmg/ddx140. [Epub ahead of print]

PMID: 28521042

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  1. First-Trimester Fetal Echocardiography: Identification of Cardiac Structures for Screening from 6 to 13 Weeks’ Gestational Age.

Hutchinson D, McBrien A, Howley L, Yamamoto Y, Sekar P, Motan T, Jain V, Savard W, Hornberger LK.

J Am Soc Echocardiogr. 2017 May 13. pii: S0894-7317(17)30217-1. doi: 10.1016/j.echo.2017.03.017. [Epub ahead of print]

PMID: 28511860

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  1. Chromosome microarray analysis in the investigation of children with congenital heart disease.

Wu XL, Li R, Fu F, Pan M, Han J, Yang X, Zhang YL, Li FT, Liao C.

BMC Pediatr. 2017 May 4;17(1):117. doi: 10.1186/s12887-017-0863-3.

PMID: 28472932 Free PMC Article

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  1. An antenatal marker of neurodevelopmental outcomes in infants with congenital heart disease.

Siddiqui S, Fifer WP, Ordonez-Retamar M, Nugent JD, Williams IA.

J Perinatol. 2017 May 4. doi: 10.1038/jp.2017.59. [Epub ahead of print]

PMID: 28471442

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  1. Usefulness of the Prenatal Echocardiogram in Fetuses With Isolated Transposition of the Great Arteries to Predict the Need for Balloon Atrial Septostomy.

Vigneswaran TV, Zidere V, Miller OI, Simpson JM, Sharland GK.

Am J Cardiol. 2017 May 1;119(9):1463-1467. doi: 10.1016/j.amjcard.2017.01.017. Epub 2017 Feb 9.

PMID: 28283176

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  1. Association of genetic polymorphisms of de novo nucleotide biosynthesis with increased CHD susceptibility in the northern Chinese population.

Jiang YC, Kuang LL, Sun SN, Duan WY, Qiao B, Wang HY.

Clin Genet. 2017 May;91(5):748-755. doi: 10.1111/cge.12874. Epub 2016 Dec 12.

PMID: 27659940

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  1. Increased regurgitant flow causes endocardial cushion defects in an avian embryonic model of congenital heart disease.

Ford SM, McPheeters MT, Wang YT, Ma P, Gu S, Strainic J, Snyder C, Rollins AM, Watanabe M, Jenkins MW.

Congenit Heart Dis. 2017 May;12(3):322-331. doi: 10.1111/chd.12443. Epub 2017 Feb 17.

PMID: 28211263

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  1. TCF21 rs12190287 Polymorphisms Are Associated with Ventricular Septal Defects in a Chinese Population.

Yang L, Gao X, Luo H, Huang Q, Su D, Tan X, Lu C.

Genet Test Mol Biomarkers. 2017 May;21(5):312-315. doi: 10.1089/gtmb.2016.0324. Epub 2017 Mar 27.

PMID: 28346832

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  1. Placental Characteristics of Fetuses With Congenital Heart Disease.

Albalawi A, Brancusi F, Askin F, Ehsanipoor R, Wang J, Burd I, Sekar P.

J Ultrasound Med. 2017 May;36(5):965-972. doi: 10.7863/ultra.16.04023. Epub 2017 Mar 4.

PMID: 28258617

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  1. Prenatal Diagnosis of a Retroesophageal Left Brachiocephalic Vein: Two Case Reports.

Cheng YKY, Law KM, Chak PK, To KF, Chan YM, Leung TY.

J Ultrasound Med. 2017 May;36(5):1065-1069. doi: 10.7863/ultra.16.05003. Epub 2017 Mar 4.

PMID: 28258609

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  1. Associations of GATA4 genetic mutations with the risk of congenital heart disease: A meta-analysis.

Zhang Y, Ai F, Zheng J, Peng B.

Medicine (Baltimore). 2017 May;96(18):e6857. doi: 10.1097/MD.0000000000006857.

PMID: 28471988 Free PMC Article

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  1. Exome sequencing reveals novel IRXI mutation in congenital heart disease.

Guo C, Wang Q, Wang Y, Yang L, Luo H, Cao XF, An L, Qiu Y, Du M, Ma X, Li H, Lu C.

Mol Med Rep. 2017 May;15(5):3193-3197. doi: 10.3892/mmr.2017.6410. Epub 2017 Mar 30.

PMID: 28358424

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  1. MicroRNA-1 upregulation promotes myocardiocyte proliferation and suppresses apoptosis during heart development.

Liu L, Yuan Y, He X, Xia X, Mo X.

Mol Med Rep. 2017 May;15(5):2837-2842. doi: 10.3892/mmr.2017.6282. Epub 2017 Mar 3.

PMID: 28260051

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  1. Myocardial deformation in fetuses with coarctation of the aorta: a case-control study.

Miranda JO, Hunter L, Tibby S, Sharland G, Miller O, Simpson JM.

Ultrasound Obstet Gynecol. 2017 May;49(5):623-629. doi: 10.1002/uog.15939.

PMID: 27072120

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  1. Abnormal Fetal Findings Associated With a Global Sphericity Index of the 4-Chamber View Below the 5th Centile.

DeVore GR, Satou G, Sklansky M.

J Ultrasound Med. 2017 May 30. doi: 10.1002/jum.14261. [Epub ahead of print]

PMID: 28556937

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  1. Antenatal diagnosis of double-outlet left atrium.

Vaksmann G, Bouzguenda I, Houyel L.

Cardiol Young. 2017 May;27(4):816-818. doi: 10.1017/S104795111600250X. Epub 2017 Jan 12.

PMID: 28077186

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  1. Prenatal diagnosis of absent pulmonary valve syndrome from first trimester onwards: novel insights into pathophysiology, associated conditions and outcome.

Gottschalk I, Jehle C, Herberg U, Breuer J, Brockmeier K, Bennink G, Hellmund A, Strizek B, Gembruch U, Geipel A, Berg C.

Ultrasound Obstet Gynecol. 2017 May;49(5):637-642. doi: 10.1002/uog.15977. Epub 2017 Apr 5.

PMID: 27240926

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