ISSN 2149-2263 | E-ISSN 2149-2271
The Anatolian Journal of Cardiology
Modified Myocardial Performance Index in Fetal Growth Disturbances as Diagnostic and Prognostic Adjunct [Anatol J Cardiol]
Anatol J Cardiol. 2023; 27(1): 34-40 | DOI: 10.14744/AnatolJCardiol.2022.2577

Modified Myocardial Performance Index in Fetal Growth Disturbances as Diagnostic and Prognostic Adjunct

Ayşe Şimşek1, Semir Köse2
1Department of Pediatric Cardiology, Democracy University Faculty of Medicine, Buca Seyfi Demirsoy Training and Research Hospital, İzmir, Türkiye
2Department of Perinatology, Buca Seyfi Demirsoy Training and Research Hospital, İzmir, Türkiye

Background: Fetal growth disturbance can be associated with cardiac dysfunction. This study aimed to assess the modified myocardial performance index in growth-restricted and appropriate for gestational age fetuses and evaluate both its prognostic value in perinatal period and also its association with adverse perinatal outcomes.
Methods: Totally 131 pregnant women were included in this prospective study. Of these, 56 cases were in study group with a diagnosis of small fetus and 75 cases were in control group with a diagnosis appropriately grown fetus. Fetal echocardiography was performed in all pregnant women to measure modified myocardial performance index. Umbilical, middle cerebral and uterine artery Doppler ultrasound parameters were measured in the study group. Small fetuses were categorized into 2 subgroups of late-onset fetal growth restriction and small for gestational age.
Results: Modified myocardial performance index was significantly higher in small fetuses compared to controls (0.45 vs. 0.37, P <.001). Newborn intensive care unit admission rates were significantly higher in small fetuses than in controls (chi-square test, P <.001). The
highest mean modified myocardial performance index was recorded in the late-onset fetal growth restriction subgroup (0.45 vs. 0.41 vs. 0.37). The sensitivity and specificity of modified myocardial performance index in predicting adverse outcomes at a cut-off value of 0.41 were 63% and 75%, respectively. There was a significant negative correlation between modified myocardial performance index values and birth weights.
Conclusions: We found higher left fetal heart modified myocardial performance index values in small fetuses indicating the presence of prenatal cardiac dysfunction. Fetal myocardial performance deteriorates in concordance with severity of growth restriction. Modified myocardial performance index can also be used to predict adverse perinatal outcomes among growth-restricted fetuses.

Keywords: Cardiac function, late-onset fetal growth restriction, modified myocardial performance index, small for gestational age

Ayşe Şimşek, Semir Köse. Modified Myocardial Performance Index in Fetal Growth Disturbances as Diagnostic and Prognostic Adjunct. Anatol J Cardiol. 2023; 27(1): 34-40

Corresponding Author: Ayşe Şimşek
Manuscript Language: English


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