Fetal Myocardial Performance Index in the Third Trimester of Pregnancy: Feasibility and Reproducibility of Conventional Spectral Doppler versus Spectral Tissue Doppler Technique

Am J Perinatol. 2021 Feb;38(3):296-303. doi: 10.1055/s-0039-1697585. Epub 2019 Oct 10.

Abstract

Objective: This study aims to compare completion rates and reproducibility of myocardial performance index (MPI) using conventional spectral Doppler versus tissue Doppler in an unselected high-risk third trimester population.

Study design: This was a prospective cross-sectional study of high-risk pregnancies at ≥28 + 0 weeks' gestation. Conventional spectral and tissue Doppler MPI of the left ventricle (LV) and right ventricle (RV) was attempted on all patients.

Results: Seventy-nine pregnancies were evaluated. LV tissue Doppler MPI was completed more frequently than LV conventional spectral Doppler MPI (63/79, 79.7% vs. 45/79, 55.7%), p-value <0.01. RV tissue Doppler MPI was completed more frequently than RV conventional spectral Doppler MPI (68/79, 86% vs. 42/79, 53.2%), p-value <0.01. In obese subjects (n = 50) LV tissue Doppler MPI was completed more frequently than LV conventional spectral Doppler MPI (37/50, 74% vs. 26/50, 52%), p-value <0.01. RV tissue Doppler MPI was completed more frequently than RV conventional spectral Doppler MPI (40/50, 80% vs. 25/50, 50%), p-value <0.01. intraclass correlation coefficient for all modalities ranged between 0.73 and 0.93, except for LV conventional spectral Doppler intraobserver variability which was 0.22.

Conclusion: Tissue Doppler had statistically higher completion rates than conventional spectral Doppler, including the obese subgroup, with evidence of strong reproducibility in the third trimester.

MeSH terms

  • Adult
  • Cross-Sectional Studies
  • Echocardiography, Doppler / methods
  • Feasibility Studies
  • Female
  • Fetal Heart / diagnostic imaging*
  • Fetal Heart / physiology*
  • Gestational Age
  • Humans
  • Myocardial Contraction / physiology*
  • Pregnancy
  • Pregnancy Trimester, Third*
  • Prospective Studies
  • Reproducibility of Results
  • Ultrasonography, Prenatal
  • Ventricular Function / physiology*
  • Young Adult