Paulo Zielinsky, Polyanna Henriques, Pedro Van Der Sand, Maria Antonia Saldanha, Gabriela Macelaro, Joana Nicoloso
Fundação Universitária de Cardiologia-IC/FUC. Universidade Federal do Rio Grande do Sul-UFRGS.
Brazil
Journal of Ultrasound in Medicine
J Ultrasound Med 2025;
DOI: 10.1002/jum.70130
Abstract
Objectives: Fetuses with ductal constriction (FDC), pulmonary hypertension and right ventricular overload after maternal exposure to PGE2 inhibitors-nonsteroidal anti-inflammatory drugs (NSAIDs) or polyphenols (PF)-have increased septum primum excursion index (SPEI), the ratio between maximal septum primum displacement and left atrial diameter. The objective of this study is to assess SPEI behavior and its correlation to mean pulmonary artery pressure (MPAP) after ductal constriction (DC) resolution.
Methods: Cohort study comparing SPEI and MPAP during and 2 weeks after DC reversal, following discontinuation of NSAIDs and PF. Criteria for DC diagnosis were systolic velocity >1.40 m/second, diastolic velocity >0.30 m/second, and pulsatility index <2.2. MPAP was estimated by Dabestani equation: MPAP = 90 – (0.62 × pulmonary artery acceleration time).
Statistical analysis: t-test and Pearson’s correlation.
Results: Fifty-two pregnant women with FDC were evaluated. Following reversal, mean PI increased from 1.89 ± 0.20 to 2.54 ± 0.27 (p < .001), mean SPEI decreased from 0.75 ± 0.13 to 0.42 ± 0.12 (p < .001), and MPAP decreased from 70.33 ± 5.52 mmHg to 53.27 ± 6.68 mmHg (p < .001), with a significant correlation between MPAP and SPEI (r = 0.690).
Conclusion: After resolution of fetal DC, the SPEI decreases, this effect being correlated with reduction in MPAP.
Category
Class I. Persistent Pulmonary Hypertension of the Newborn
Diagnostic Testing for Pulmonary Vascular Disease. Non-invasive Testing
Age Focus: Pediatric Pulmonary Vascular Disease
Fresh or Filed Publication: Fresh (PHresh). Less than 1-2 years since publication
Article Access
Free PDF File or Full Text Article Available Through PubMed or DOI: Yes