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1.
Rev. chil. cardiol ; 42(3): 172-178, dic. 2023.
Article in Spanish | LILACS | ID: biblio-1529984

ABSTRACT

La miocardiopatía hipertrófica (MCH) es la miocardiopatía hereditaria más frecuente, su principal expresión fenotípica consiste en hipertrofia ventricular izquierda (HVI) en ausencia de condiciones de carga que la justifiquen. Cuando existe una variante genética patogénica se denomina MCH sarcomérica. Los criterios diagnósticos más aceptados son HVI ≥ 15 mm en cualquier segmento o ≥ 13 en ciertas condiciones, criterios que tienen tres inconvenientes: 1) La HCM es una patología donde la HVI es evolutiva, existiendo otros elementos más precoces, pero menos precisos, como criptas, bandas musculares y alteraciones de la válvula mitral y músculos papilares; 2) Pacientes de baja estatura pueden no alcanzar estos umbrales; 3) La MCH apical no queda siempre bien representada usando estos grosores, requiriendo indexar por tamaño del paciente y/o considerar la HVI relativa (relación grosor apical / basal que no debe superar 1). Presentamos una serie de casos con genotipo confirmado para MCH que no cumplen los criterios de HVI aceptados para MCH y donde se debe individualizar el diagnóstico considerando los tres elementos señalados.


Hypertrophic cardiomyopathy (HCM) is the most common inherited cardiac condition; its phenotypic expression consists of ventricular hypertrophy (LVH) unrelated to loading conditions. In patients with a genetic pathogenic variant, the condition is termed sarcomeric HCM. Current diagnostic criteria are based on absolute left ventricular thickness, requiring ≥15 mm in any segment or ≥13 mm in particular conditions. These criteria have three pitfalls: 1) HCM is an evolving disease where LVH occurs gradually, with other early -but less precisephenotypic expressions such as myocardial crypts, muscular bands, or mitral and papillary muscle alterations; 2) Patients with short stature tend to have less LVH and do not reach the proposed thickness threshold. 3) Apical HCM is not correctly addressed in this cut-off as the heart tapers from base to apex, warranting indexing wall thickness to body size and using relative LVH in the apex (ratio from apex/base, abnormal,>1). This small case series includes three patients with a pathogenic genetic variant for HCM that doesn't satisfy the current criteria of LVH. For its precise assessment, the aforementioned points must be considered.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Cardiomyopathy, Hypertrophic/pathology , Hypertrophy, Left Ventricular/pathology , Cardiomyopathy, Hypertrophic/complications , Cardiomyopathy, Hypertrophic/diagnosis , Cardiomyopathy, Hypertrophic/genetics , Magnetic Resonance Spectroscopy , Echocardiography, Doppler , Genetic Testing , Hypertrophy, Left Ventricular/genetics , Heart/anatomy & histology
3.
ABC., imagem cardiovasc ; 36(1): e20230002, abr. 2023. ilus, tab
Article in Portuguese | LILACS | ID: biblio-1452586

ABSTRACT

A prática regular de esportes pode induzir adaptações no coração, sendo essa condição comumente chamada de "coração de atleta". As alterações observadas incluem dilatação das câmaras cardíacas, aumento da espessura miocárdica, melhora do enchimento ventricular, aumento da trabeculação do ventrículo esquerdo (VE), dilatação da veia cava inferior, entre outras. Essas alterações também podem ser observadas em algumas doenças cardíacas, como cardiomiopatia (CMP) dilatada, hipertrófica e outras. Dessa forma, os exames de imagem cardíaca são fundamentais na identificação dessas alterações e na diferenciação entre o "coração de atleta" e uma possível cardiopatia.(AU)


Exercise-induced adaptation may occur in amateur and professional athletes. This condition is commonly named "athlete's heart". The alterations observed include dilation of the heart chambers, increased myocardial thickness, improved ventricular filling, increased left ventricular trabeculation, dilation of the inferior vena cava, among others. These changes can also be observed in some heart diseases, such as dilated, hypertrophic and other cardiomyopathies (CMP). Thus, cardiac imaging tests are fundamental in identifying these alterations and in differentiating between "athlete's heart" and possible heart disease. (AU)


Subject(s)
Humans , Male , Female , Child , Adolescent , Adult , Cardiomyopathy, Dilated/diagnosis , Cardiomegaly, Exercise-Induced/physiology , Heart/anatomy & histology , Heart/diagnostic imaging , Echocardiography/methods , Magnetic Resonance Spectroscopy/methods , Radiography, Thoracic/methods , Echocardiography, Doppler/methods , Exercise/physiology , Electrocardiography/methods
4.
Medicentro (Villa Clara) ; 27(1)mar. 2023.
Article in Spanish | LILACS | ID: biblio-1440522

ABSTRACT

La artritis reumatoide es una enfermedad progresiva, con manifestaciones clásicas y tempranas como es la afectación de las articulaciones pequeñas de las manos y los tobillos. Se realizó una revisión bibliográfica de los documentos publicados entre 2017 y 2022. Se realizó una lectura preliminar de 37 artículos que cumplían con los criterios de inclusión, y finalmente se seleccionaron 23 artículos, de los cuales se tomó el contenido de mayor importancia. La ecografía es una técnica fiable y más sensible que la exploración clínica en el estudio de la enfermedad músculo-esquelética, pues permite una exploración multiplanar y dinámica, lo que resulta en un diagnóstico más exacto. La técnica Doppler constituye un complemento útil en el seguimiento de estos pacientes. Esta enfermedad es recurrente en las consultas de Reumatología, por tanto, en su valoración inicial, la utilidad de los medios diagnósticos, especialmente la ecografía, tiene gran importancia.


Rheumatoid arthritis is a progressive disease, with classic and early manifestations such as involvement of the small joints of the hands and ankles. We conducted a bibliographic review of the documents published between 2017 and 2022. A preliminary reading of 37 articles that met the inclusion criteria was carried out, and 23 articles were finally selected, from which the most important content was taken. Ultrasound is a more sensitive and reliable technique than clinical examination for the study of musculoskeletal disease, since it allows a multiplanar and dynamic examination, which results in a more accurate diagnosis. Doppler technique is a useful complement in the follow-up of these patients. This disease is recurrent in Rheumatology consultations, that's why in its initial assessment, the usefulness of diagnostic means, especially ultrasound, is of great importance.


Subject(s)
Arthritis, Rheumatoid , Rheumatology , Echocardiography, Doppler
5.
Chinese Medical Journal ; (24): 1198-1206, 2023.
Article in English | WPRIM | ID: wpr-980888

ABSTRACT

BACKGROUND@#Right ventricular (RV)-arterial uncoupling is a powerful independent predictor of prognosis in heart failure with preserved ejection fraction (HFpEF). Coronary artery disease (CAD) can contribute to the pathophysiological characteristics of HFpEF. This study aimed to evaluate the prognostic value of RV-arterial uncoupling in acute HFpEF patients with CAD.@*METHODS@#This prospective study included 250 consecutive acute HFpEF patients with CAD. Patients were divided into RV-arterial uncoupling and coupling groups by the optimal cutoff value, based on a receiver operating characteristic curve of tricuspid annular plane systolic excursion to pulmonary artery systolic pressure (TAPSE/PASP). The primary endpoint was a composite of all-cause death, recurrent ischemic events, and HF hospitalizations.@*RESULTS@#TAPSE/PASP ≤0.43 provided good accuracy in identifying patients with RV-arterial uncoupling (area under the curve, 0.731; sensitivity, 61.4%; and specificity, 76.6%). Of the 250 patients, 150 and 100 patients could be grouped into the RV-arterial coupling (TAPSE/PASP >0.43) and uncoupling (TAPSE/PASP ≤0.43) groups, respectively. Revascularization strategies were slightly different between groups; the RV-arterial uncoupling group had a lower rate of complete revascularization (37.0% [37/100] vs . 52.7% [79/150], P <0.001) and a higher rate of no revascularization (18.0% [18/100] vs . 4.7% [7/150], P <0.001) compared to the RV-arterial coupling group. The cohort with TAPSE/PASP ≤0.43 had a significantly worse prognosis than the cohort with TAPSE/PASP >0.43. Multivariate Cox analysis showed TAPSE/PASP ≤0.43 as an independent associated factor for the primary endpoint, all-cause death, and recurrent HF hospitalization (hazard ratios [HR]: 2.21, 95% confidence interval [CI]: 1.44-3.39, P <0.001; HR: 3.32, 95% CI: 1.30-8.47, P = 0.012; and HR: 1.93, 95% CI: 1.10-3.37, P = 0.021, respectively), but not for recurrent ischemic events (HR: 1.48, 95% CI: 0.75-2.90, P = 0.257).@*CONCLUSION@#RV-arterial uncoupling, based on TAPSE/PASP, is independently associated with adverse outcomes in acute HFpEF patients with CAD.


Subject(s)
Humans , Prognosis , Prospective Studies , Stroke Volume/physiology , Echocardiography, Doppler/adverse effects , Coronary Artery Disease/complications , Heart Failure , Pulmonary Artery/diagnostic imaging , Ventricular Function, Right/physiology , Ventricular Dysfunction, Right
6.
Rev. urug. cardiol ; 38(1): e301, 2023. ilus, tab
Article in Spanish | BNUY, UY-BNMED, LILACS | ID: biblio-1442150

ABSTRACT

La amiloidosis cardíaca es una miocardiopatía restrictiva infiltrativa secundaria al depósito extracelular de amiloide. Las diferentes técnicas de imagen cardíaca permiten la evaluación de forma no invasiva. El ecocardiograma juega un rol central en la evaluación diagnóstica, pronóstica y ayuda a guiar el tratamiento. El objetivo de este artículo de revisión es describir las diferentes herramientas que nos brinda la ecocardiografía, poniendo énfasis en el strain por speckle tracking y describir su rol en el diagnóstico de esta patología.


Cardiac amyloidosis is an infiltrative restrictive cardiomyopathy secondary to extracellular amyloid deposition. Different cardiac imaging techniques allow noninvasive evaluation. Echocardiography plays a central role in diagnostic and prognostic evaluation and helps to guide treatment. The aim of this review is to describe the different tools provided by echocardiography, with emphasis on speckle tracking strain and to describe its role in the diagnosis of this pathology.


A amiloidose cardíaca é uma cardiomiopatia restritiva infiltrativa secundária ao depósito de amiloide extracelular. Diferentes técnicas de imagem cardíaca permitem fazer uma análise não invasiva. A ecocardiografia desempenha um papel central no diagnóstico e na avaliação prognóstica e ajuda a orientar o tratamento. O objetivo deste artigo de revisão é descrever as diferentes ferramentas proporcionadas pela ecocardiografia, com ênfase no strain por speckle tracking, e descrever o seu papel no diagnóstico desta patologia.


Subject(s)
Echocardiography, Doppler/methods , Heart Diseases/diagnostic imaging , Amyloidosis/diagnostic imaging , Prognosis , Sensitivity and Specificity , Echocardiography, Transesophageal/methods
7.
Rev. chil. cardiol ; 41(3): 186-189, dic. 2022. ilus
Article in Spanish | LILACS | ID: biblio-1423691

ABSTRACT

Se presentan dos casos clínicos de "criscross" de ramas pulmonares, una forma infrecuente de malformación del origen de estas arterias desde lados opuestos del tronco pulmonar y cuyos trayectos se cruzan en su camino hacia sus respectivos pulmones. De manera aislada es una condición benigna, sin consecuencias hemodinámicas y de buen pronóstico.


Two clinical cases of "crisscrossed" pulmonary arteries are presented. This is an unusual malformation in which arteries from opposite sides of the pulmonary trunk cross along their course towards their respective lungs. Usually, it is a benign condition when found as an isolated malformation, with no hemodynamic consequences and good prognosis.


Subject(s)
Humans , Female , Infant, Newborn , Pulmonary Artery/abnormalities , Pulmonary Artery/diagnostic imaging , Heart Defects, Congenital/diagnostic imaging , Echocardiography, Doppler
8.
Rev. cuba. cir ; 61(2)jun. 2022.
Article in Spanish | LILACS, CUMED | ID: biblio-1408248

ABSTRACT

Introducción: La pileflebitis, trombosis séptica del sistema portal por cuadros inflamatorios agudos abdominales, se presenta con manifestaciones clínicas variables en dependencia de la causa de origen y por rama portal afectado. El diagnóstico incluye función hepática normal o ligeramente alterada con leucocitosis, hemocultivos positivos, eco doppler o tomografía computarizada que corrobore la enfermedad. Objetivo: Describir la pileflebitis como una complicación inusual en una paciente embarazada con apendicitis aguda, desde su concepto, fisiopatología, presentación clínica, diagnóstico y medidas terapéuticas. Caso clínico: Paciente femenina de 18 años, gestante, que refirió dolor abdominal de gran intensidad, acompañado de vómito y deposiciones diarreicas y tinte ictérico. Por tales motivos fue trasladada al Hospital General Docente Ambato. Se diagnosticó sepsis de origen abdominal por apendicitis aguda perforada, peritonitis generalizada complicada con pileflebitis. Se realizó intervención quirúrgica y resolución del cuadro clínico. Conclusiones: La pileflebitis presenta una gran dificultad diagnóstica, por lo que herramientas como la ecografía doppler y la tomografía computarizada son de ayuda en estos casos. Los pilares del tratamiento incluyen control del foco séptico abdominal y tratar la pileflebitis(AU)


Introduction: Pylephlebitis, septic thrombosis of the portal system due to acute abdominal inflammatory conditions, it presents with variable clinical signs depending on the cause of origin and the affected portal branch. Diagnosis includes normal or mildly impaired liver function with leukocytosis, positive blood cultures, Doppler echocardiography, or computed tomography confirming the disease. Objective: To describe pylephlebitis as an unusual complication in a pregnant patient with acute appendicitis, referring to its concept, pathophysiology, clinical presentation, diagnosis and therapeutic measures. Clinical case report: This is the case of an 18-year-old female pregnant patient, who had severe abdominal pain, accompanied by vomiting, diarrhea and jaundiced stools. For such reasons, she was transferred to the Ambato General Teaching Hospital. Sepsis of abdominal origin was diagnosed due to acute perforated appendicitis, generalized peritonitis complicated with pylephlebitis. Surgical intervention was performed and the clinical condition was solved. Conclusions: Pylephlebitis represents a great diagnostic difficulty, hence tools such as Doppler ultrasound and computed tomography are helpful in these cases. The mainstays of treatment include control of the abdominal septic focus and treating pylephlebitis(AU)


Subject(s)
Humans , Female , Adolescent , Appendicitis/complications , Peritonitis , Surgical Procedures, Operative , Echocardiography, Doppler/methods , Vomiting , Tomography, X-Ray Computed , Ultrasonography, Doppler
10.
ABC., imagem cardiovasc ; 35(3): eabc331, 2022. ilus, tab
Article in Portuguese | LILACS | ID: biblio-1411428

ABSTRACT

Introdução: A esclerose sistêmica (ES) é uma doença autoimune do tecido conjuntivo que cursa com fibrose e disfunção microvascular. O envolvimento dos órgãos viscerais, incluindo os pulmões e o coração, é a principal causa de óbito na ES. Nesse contexto, analisamos a relação entre os parâmetros ventriculares direitos (VD) pela ecocardiografia com Doppler tecidual e o acometimento pulmonar em pacientes com ES. Métodos: Os pacientes que preencheram os Critérios de Classificação da ES de 2013 foram submetidos à ecocardiografia com Doppler tecidual para avaliação da função sistólica (fração de ejeção) ventricular esquerda (VE), enquanto a função sistólica do VD foi avaliada por meio da fração de variação de área do VD (fractional area change ­ FAC), velocidade (sistólica) do Doppler tecidual, índice de desempenho miocárdico (IDM) e excursão sistólica do plano anular tricúspide (TAPSE). A pressão sistólica pulmonar foi estimada por insuficiência tricúspide. A tomografia computadorizada de alta resolução (TCAR) de tórax avaliou a presença de fibrose pulmonar. De acordo com os resultados da TCAR, os pacientes foram divididos em 2 subgrupos: Grupo I, incluindo pacientes com fibrose pulmonar (n=26), e Grupo II sem fibrose (n=17). Resultados: Entre os 43 pacientes com ES, a maioria era do sexo feminino (86%) com idade de 51±12 anos. Todos os pacientes apresentavam função ventricular sistólica normal, avaliada pela FEVE>55% e FAC VD>35%. Não houve diferença significativa em termos de idade ou duração da doença para os grupos. Exceto pela diminuição das velocidades do Doppler tecidual em pacientes com fibrose pulmonar, todos os índices de desempenho do VD foram semelhantes. Conclusão: Em pacientes com ES e fibrose pulmonar, o Doppler tecidual identifica acometimento miocárdico longitudinal precoce do VD, apesar do desempenho sistólico radial preservado do VD.(AU)


Introduction: Systemic sclerosis (SSc) is an autoimmune tissue connective disease that courses with fibrosis and microvascular dysfunction. Involvement of the visceral organs, including the lungs and heart, is the main cause of death among patients with SSc. In this context, here we analyzed the relationship between right ventricle (RV) parameters assessed by tissue Doppler echocardiography and lung involvement in patients with SSc. Methods: Patients fulfilling the 2013 SSc Classification Criteria underwent tissue Doppler echocardiography for the assessment of left ventricular (LV) systolic function (ejection fraction) and RV fractional area change (FAC), tissue Doppler s' (systolic) velocity, myocardial performance index, and tricuspid annular plane systolic excursion for the assessment of RV systolic function. Pulmonary systolic pressure was estimated using tricuspid regurgitation. Chest high-resolution computed tomography was used to evaluate the presence of pulmonary fibrosis. The patients were divided into two subgroups accordingly: Group I, patients with pulmonary fibrosis (n=26); and Group II, those without fibrosis (n=17). Results: Among the 43 patients with SSc, most were female (86%), and the mean age was 51 ± 12 years. All patients had normal systolic ventricular function as evidenced by an LV ejection fraction > 55% and an RV FAC > 35%. No significant intergroup difference was noted in age or disease duration. Except for a decreased tissue Doppler s' velocity in patients with lung fibrosis, all indexes of RV performance were similar. Conclusion: In patients with SSc and pulmonary fibrosis, tissue Doppler identified early RV longitudinal myocardial involvement despite preserved RV radial systolic performance.(AU)


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Young Adult , Pulmonary Fibrosis/complications , Scleroderma, Systemic/diagnosis , Ventricular Function, Right , Lung Diseases, Interstitial/diagnosis , Thorax/diagnostic imaging , Tricuspid Valve Insufficiency/complications , Echocardiography, Doppler/methods , Tomography, X-Ray Computed/methods
11.
ABC., imagem cardiovasc ; 35(3): eabc280, 2022. tab, ilus
Article in Portuguese | LILACS | ID: biblio-1411955

ABSTRACT

Cor triatriatum é um anomalia cardíaca congênita rara frequentemente diagnosticada na primeira infância. Este estudo de caso apresenta um adulto com um achado acidental de cor triatriatum sinistrum. Com base na apresentação clínica, o paciente foi tratado de forma conservadora. São apresentados achados de imagens ecocardiográficas de cor triatriatum sinistrum deste paciente juntamente de revisão narrativa da literatura sobre essa doença.(AU)


Cor triatriatum is a rare congenital heart anomaly often diagnosed in early childhood. This case study features an adult with an incidental finding of cor triatriatum sinistrum. Based on the clinical presentation, the patient was treated conservatively. Cor triatriatum sinistrum echocardiographic image findings of this patient are presented along with a narrative review of the literature about this disease. (AU)


Subject(s)
Humans , Male , Middle Aged , Cor Triatriatum/complications , Cor Triatriatum/diagnostic imaging , Incidental Findings , Heart Atria/abnormalities , Magnetic Resonance Spectroscopy/methods , Echocardiography, Doppler/methods , Echocardiography, Transesophageal/methods , Echocardiography, Three-Dimensional/methods , Fatty Liver/complications , Heart Septal Defects, Atrial/complications , Kidney/injuries , Myocardial Infarction/genetics
18.
Rev. chil. cardiol ; 40(3): 234-238, dic. 2021. ilus
Article in Spanish | LILACS | ID: biblio-1388100

ABSTRACT

Resumen Se presenta el caso de un paciente de 54 años que consulta por angina de esfuerzo de 2 años de evolución en quien se identifica una dilatación ectásica del árbol coronario con lesiones ateroscleróticas críticas y miocardiopatía hipertrófica septal obstructiva. Una revisión bibliográfica revela que es una asociación infrecuente de la cual solo existen reportes de casos aislados.


Abstract We present the case of a 54-year-old patient who presented with a history of 2 years with angina. Invasive studies revealed critical coronary artery stenosis coexisting with obstructive hypertrophic miopathy. This is a rare association with only isolated case reports.


Subject(s)
Humans , Male , Middle Aged , Cardiomyopathy, Hypertrophic/complications , Cardiomyopathy, Hypertrophic/diagnostic imaging , Atherosclerosis/complications , Atherosclerosis/diagnostic imaging , Cardiomyopathy, Hypertrophic/surgery , Echocardiography, Doppler , Dilatation, Pathologic , Atherosclerosis/surgery , Computed Tomography Angiography
19.
Rev. cuba. angiol. cir. vasc ; 22(2): e313, 2021. graf
Article in Spanish | LILACS, CUMED | ID: biblio-1289367

ABSTRACT

Introducción: La arteria femoral común y sus ramas suministran la mayor parte del flujo sanguíneo al muslo, así como a la totalidad de la pierna y el pie, lo que da lugar a la mayor rama del triángulo femoral: la arteria femoral profunda. Objetivo: Exponer la efectividad de la profundaplastia femoral en la "era endovascular". Reporte del caso: Se presenta un caso de enfermedad arterial periférica de múltiples sectores, sin criterio de cirugía revascularizadora (derivación protésica aorto bifemoral). El paciente manifestaba claudicación intermitente a menos de 30 metros, localizada en pantorrilla derecha. En el estudio hemodinámico se apreciaron los índices de presiones tobillo/brazo disminuidos en arteria tibial posterior (0,46) y pedia derecha (0,33). La ecografía doppler del sector femoral derecho evidenció una estenosis de la arteria femoral profunda en su origen, que producía aumento de las velocidades picos sistólicos (479 cm/s), con flujo desorganizado, dilatación posestenótica y oclusión de la arteria femoral superficial en su origen. Se realizó endarterectomía femoral común y profunda con colocación de parche de politetrafloroetileno. El paciente evolucionó sin complicaciones posoperatorias. En el seguimiento se observó mejoría clínica en relación con la distancia de claudicación y un aumento de los índices de presiones tobillo/brazo en arteria tibial posterior y pedia derecha (0,50), respectivamente. Conclusiones: La profundaplastia femoral, aún en la "era endovascular", permanece como un proceder eficaz que resulta alternativa de tratamiento revascularizador en la enfermedad arterial periférica de localización infrainguinal(AU)


Introduction: The normal femoral artery and its branches supply most of the blood flow to the thigh, as well as to the whole leg and foot, which forms the largest branch of the femoral triangle: the deep femoral artery. Objective: Show the effectiveness of femoral deep plasty in the "endovascular era". Case report: It is presented a case of peripheral artery disease in multiple sectors, without surgical criteria of revascularization (derivación protésica aortobifemoral). The patient presented intermittent claudication in less than 30 meters, and it was located in the right calf. In the hemodynamic study, the ankle-arm pressure indexes were dicreased in the posterior tibial artery (0,46) and right dorsalis pedis artery (0,33). The doppler echocardiography of the right femoral sector confirmed a stenosis in the deep femoral artery in its origin, which produced an increase in the peak systolic velocity (479 cm/s), unorganized flows, poststenotic dilatation and occlusion of the superficial femoral artery in its origin. It was performed a common and deep femoral endarterectomy with colocation of polytetrafluoroethylene patch. The patient evolved without post-surgical complications. In the follow-up, it was observed a clinical improvement in relation with the claudication distance and the increase of the ankle-arm pressure indexes in the posterior tibial artery and right dorsalis pedis artery (0,50), respectively. Conclusions: The femoral deep plasty, still in the ´´endovascular era´´, is an efficient procedure that is an alternative to the revascularization treatment in the peripheral artery disease with infrainguinal location(AU)


Subject(s)
Humans , Male , Middle Aged , Echocardiography, Doppler/methods , Endarterectomy/methods , Femoral Artery/surgery , Peripheral Arterial Disease/etiology , Research Report
20.
Rev. Bras. Saúde Mater. Infant. (Online) ; 21(2): 631-637, Apr.-June 2021. tab, graf
Article in English | LILACS | ID: biblio-1340663

ABSTRACT

Abstract Objectives: the aim of this study was to determine the prevalence of fetal tricuspid valve regurgitation (TR) during the third trimester of low-risk pregnancies and to assess its clinical significance on neonates. Methods: this is a cross-sectional study including 330 singleton fetuses referred for routine fetal echocardiography during 3rd trimester in a fetal medicine center in Recife, Brazil. The presence and degree of tricuspid regurgitation were analyzed. Whenever TR was identified on fetal echocardiography, postnatal data, including the results of postnatal echocardiography were reviewed. Results: the prevalence of tricuspid regurgitation was 10.0% (n=33) in the study population. Regarding regurgitation degree, 90.9% (n=30) presented mild regurgitation and none presented important TR. Postnatal data was obtained from 21 neonates. Twenty of them were discharged without any complications, and one presented respiratory distress due to prematurity. Transthoracic echocardiography was performed in 66.7% (n=14) of the neonates and it was normal in 92.9% (n=13) of them. One neonate, 7.1%, persisted with tricuspid regurgitation, but had no other findings. Conclusions: tricuspid regurgitation in fetuses with normal cardiac anatomy during the 3rd trimester is a common condition in low-risk pregnancies, and is not associated with cardiac abnormalities or need for neonatal intervention.


Resumo Objetivos: determinar a prevalência da regurgitação tricúspide (RT) em fetos no terceiro trimestre de gestações de baixo risco e investigar sua repercussão clínica nos recémnascidos. Métodos: trata-se de um estudo transversal incluindo 330 fetos encaminhados para realização de ecocardiograma fetal de rotina no terceiro trimestre da gestação num centro de medicina fetal em Recife, Brasil. A presença e o grau de insuficiência tricúspide foram estudados. Quando RT estava presente ao ecocardiograma fetal dados pós-natais, incluindo ecocardiograma, também foram analisados. Resultados: a prevalência de RT foi de 10,0% na população estudada, sendo que 90,9% (n=30) dos casos foram classificados como RT leve, e nenhum caso de RT importante foi identificado. Foram obtidos dados pós-natais de 21 recém-nascidos. Destes, 20 receberam alta hospitalar sem nenhuma complicação, enquanto 1 apresentou desconforto respiratório associado à prematuridade. Ecocardiograma transtorácico foi realizado em 66.7% (n=14) dos recém-nascidos avaliados, e foi normal em 92.9% (n=13) deles. Apenas 1 recém-nascido, 7.1%, persistiu com RT mas sem outros achados significativos. Conclusões: a RT em fetos com anatomia cardíaca normal é comum no terceiro trimestre de gestações de baixo risco e não parece associar-se a anomalias cardíacas ou necessidade de intervenção no período neonatal.


Subject(s)
Humans , Female , Pregnancy , Infant, Newborn , Pregnancy Trimester, Third , Tricuspid Valve Insufficiency/diagnosis , Tricuspid Valve Insufficiency/epidemiology , Echocardiography, Doppler/methods , Fetus/abnormalities , Fetus/diagnostic imaging , Heart Defects, Congenital , Postnatal Care , Prenatal Diagnosis , Brazil/epidemiology , Infant, Premature , Cross-Sectional Studies , Cardiovascular Abnormalities
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