Usefulness of myocardial tissue Doppler vs conventional echocardiography in the evaluation of cardiac dysfunction in early-onset intrauterine growth restriction

OBJECTIVE: To evaluate cardiac function by tissue Doppler imaging vs conventional echocardiography in intrauterine growth restriction. STUDY DESIGN: A prospective study in 25 intrauterine growth restriction, and in 50 normally grown fetuses between 24 and 34 weeks. Conventional echocardiography (E/A ratios, outflow tract velocities and myocardial performance index), and tissue Doppler (myocardial peak velocities, E'/A' ratios and myocardial performance index') measurements were performed. RESULTS: With conventional echocardiography, intrauterine growth restriction fetuses showed an increase in left myocardial performance index but similar values of E/A ratios, outflow tract velocities and right myocardial performance index as compared with controls. Tissue Doppler imaging demonstrated that intrauterine growth restriction fetuses had significantly lower systolic and diastolic myocardial velocities in mitral and tricuspid annulus, higher mitral E'/A' ratio and higher mitral, tricuspid and septal myocardial performance index' values. CONCLUSION: Tissue Doppler imaging demonstrated the presence of both systolic and diastolic cardiac dysfunction in intrauterine growth restriction. Tissue Doppler imaging may constitute a more sensitive tool than conventional echocardiography to evaluate cardiac dysfunction in intrauterine growth restriction.