Third Trimester Myocardial Performance Index in Fetuses from Women with Hyperglycemia in Pregnancy: A Systematic Review and Meta-Analysis

2021 ◽  
Author(s):  
Angelo Sirico ◽  
Antonio Raffone ◽  
Giuseppe Maria Maruotti ◽  
Antonio Travaglino ◽  
Carmela Paciullo ◽  
...  
Keyword(s):  
Subgroup Analysis ◽  
Cardiac Dysfunction ◽  
Performance Index ◽  
Myocardial Performance Index ◽  
Control Group ◽  
Healthy Controls ◽  
Myocardial Performance ◽  
Third Trimester ◽  
Potential Marker ◽  
In Pregnancy

Abstract Introduction The myocardial performance index (MPI) has been proposed to evaluate cardiac dysfunction in newborns from diabetic mothers. Although MPI is routinely assessed in newborns, its role in the evaluation of fetuses from women with hyperglycemia in pregnancy (HIP) is still under evaluation. We aimed to evaluate the differences in third trimester fetal MPI in pregnant women with hyperglycemia compared to healthy controls. Materials and Methods Seven electronic databases were searched for all studies assessing women with HIP who underwent evaluation of fetal left MPI during pregnancy compared to a control group. The summary measures were reported as mean differences (MD) in the mean fetal left MPI between women with HIP and healthy controls, with a 95 % confidence interval (CI). A post hoc subgroup analysis based on the type of HIP – pregestational diabetes, GDM, or gestational impaired glucose tolerance (GIGT) – was performed as an additional analysis. Results 14 studies assessing 1326 fetuses (580 from women with HIP and 746 from controls) were included. Women with HIP had a significantly higher mean left fetal MPI compared to controls (MD 0.08; 95 %CI: 0.05 to 0.11; p < 0.00 001). Subgroup analysis according to the type of HIP concurred with the overall analysis for women with DM (MD 0.07; 95 %CI: 0.01 to 0.13; p = 0.02) and for women with GDM (MD 0.012; 95 %CI: 0.07 to 0.17; p < 0.00 001) but not for women with GIGT (MD –0.01, 95 % CI –0.28 to 0.27; p = 0.96). Conclusion Fetal left MPI is increased in pregnancies with HIP appearing as a potential marker of cardiac dysfunction.

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

2019 ◽  
Author(s):  
Lea M. Porche ◽  
Elena Sinkovskaya ◽  
Rachel D. Seaman ◽  
Hadiza Galadima ◽  
Letty Romary ◽  
...  
Keyword(s):  
High Risk ◽  
Performance Index ◽  
Tissue Doppler ◽  
Myocardial Performance Index ◽  
P Value ◽  
Myocardial Performance ◽  
Completion Rates ◽  
Third Trimester ◽  
The Third ◽  
Spectral Doppler

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.

Partial deletion of ROCK2 protects mice from high-fat diet-induced cardiac insulin resistance and contractile dysfunction

2015 ◽  
Vol 309 (1) ◽  
pp. H70-H81 ◽  
Author(s):  
Hesham Soliman ◽  
Vongai Nyamandi ◽  
Marysol Garcia-Patino ◽  
Julia Nogueira Varela ◽  
Girish Bankar ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Cardiac Dysfunction ◽  
Performance Index ◽  
High Fat Diet ◽  
Left Ventricular ◽  
Myocardial Performance Index ◽  
Contractile Dysfunction ◽  
Myocardial Performance ◽  
High Fat ◽  
Glut4 Expression

Obesity is associated with cardiac insulin resistance and contractile dysfunction, which contribute to the development of heart failure. The RhoA-Rho kinase (ROCK) pathway has been reported to modulate insulin resistance, but whether it is implicated in obesity-induced cardiac dysfunction is not known. To test this, wild-type (WT) and ROCK2+/− mice were fed normal chow or a high-fat diet (HFD) for 17 wk. Whole body insulin resistance, determined by an insulin tolerance test, was observed in HFD-WT, but not HFD-ROCK2+/−, mice. The echocardiographically determined myocardial performance index, a measure of global systolic and diastolic function, was significantly increased in HFD-WT mice, indicating a deterioration of cardiac function. However, no change in myocardial performance index was found in hearts from HFD-ROCK2+/− mice. Speckle-tracking-based strain echocardiography also revealed regional impairment in left ventricular wall motion in hearts from HFD-WT, but not HFD-ROCK2+/−, mice. Activity of ROCK1 and ROCK2 was significantly increased in hearts from HFD-WT mice, and GLUT4 expression was significantly reduced. Insulin-induced phosphorylation of insulin receptor substrate (IRS) Tyr612, Akt, and AS160 was also impaired in these hearts, while Ser307 phosphorylation of IRS was increased. In contrast, the increase in ROCK2, but not ROCK1, activity was prevented in hearts from HFD-ROCK2+/− mice, and cardiac levels of TNFα were reduced. This was associated with normalization of IRS phosphorylation, downstream insulin signaling, and GLUT4 expression. These data suggest that increased activation of ROCK2 contributes to obesity-induced cardiac dysfunction and insulin resistance and that inhibition of ROCK2 may constitute a novel approach to treat this condition.

scholarly journals Tissue Doppler Echocardiography and Myocardial Performance Index in Patients with Scleroderma

2005 ◽  
Vol 33 (4) ◽  
pp. 417-425 ◽  
Author(s):  
S Güllülü ◽  
AA Kaderli ◽  
A Ekbul ◽  
B Özdemir ◽  
İ Baran ◽  
...  
Keyword(s):  
Doppler Echocardiography ◽  
Performance Index ◽  
Tissue Doppler ◽  
Left Ventricular ◽  
Myocardial Performance Index ◽  
Tissue Doppler Echocardiography ◽  
Doppler Imaging ◽  
Control Group ◽  
Myocardial Performance ◽  
Ventricular Functions

In this study, left and right ventricular functions were examined echocardiographically in 22 patients with scleroderma and 22 healthy volunteers. Conventional and tissue Doppler echocardiography and myocardial performance indexes were used as measures of right and left ventricular global functions. Mitral early diastolic E wave deceleration time, isovolumetric contraction time and left ventricular myocardial performance index and peak tricuspid A wave velocity were significantly higher in the scleroderma group compared with the control group. Mitral and tricuspid E/A ratios were significantly lower in patients with scleroderma. In addition, mitral annular and tricuspid annular isovolumetric relaxation times and the tricuspid E/E' ratio were significantly increased in scleroderma patients compared with the control group. In conclusion, in scleroderma patients the global left ventricular functions were depressed and diastolic function abnormalities were seen in both right and left ventricles. In addition, longitudinal muscle functions of the ventricles were depressed in scleroderma patients, as shown by tissue Doppler imaging parameters.

Noninvasive Doppler-derived myocardial performance index in rats with myocardial infarction: validation and correlation by conductance catheter

2006 ◽  
Vol 290 (4) ◽  
pp. H1540-H1548 ◽  
Author(s):  
David Jegger ◽  
Xavier Jeanrenaud ◽  
Mohammad Nasratullah ◽  
Pierre-Guy Chassot ◽  
Ajit Mallik ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Performance Index ◽  
Left Ventricular ◽  
Myocardial Performance Index ◽  
Control Group ◽  
Coronary Artery Ligation ◽  
Stroke Work ◽  
Myocardial Performance ◽  
Conductance Catheter

The rodent model of myocardial infarction (MI) is extensively used in heart failure studies. However, long-term follow-up of echocardiographic left ventricular (LV) function parameters such as the myocardial performance index (MPI) and its ratio with the fractional shortening (LVFS/MPI) has not been validated in conjunction with invasive indexes, such as those derived from the conductance catheter (CC). Sprague-Dawley rats with left anterior descending coronary artery ligation (MI group, n = 9) were compared with a sham-operated control group ( n = 10) without MI. Transthoracic echocardiography (TTE) was performed every 2 wk over an 8-wk period, after which classic TTE parameters, especially MPI and LVFS/MPI, were compared with invasive indexes obtained by using a CC. Serial TTE data showed significant alterations in the majority of the noninvasive functional and structural parameters (classic and novel) studied in the presence of MI. Both MPI and LVFS/MPI significantly ( P < 0.05 for all reported values) correlated with body weight ( r = −0.58 and 0.76 for MPI and LVFS/MPI, respectively), preload recruitable stroke work ( r = −0.61 and 0.63), LV end-diastolic pressure (LVEDP) ( r = 0.82 and −0.80), end-diastolic volume ( r = 0.61 and −0.58), and end-systolic volume ( r = 0.46 and −0.48). Forward stepwise linear regression analysis revealed that, of all variables tested, LVEDP was the only independent determinant of MPI ( r = 0.84) and LVFS/MPI ( r = 0.83). We conclude that MPI and LVFS/MPI correlate strongly and better than the classic noninvasive TTE parameters with established, invasively assessed indexes of contractility, preload, and volumetry. These findings support the use of these two new noninvasive indexes for long-term analysis of the post-MI LV remodeling.

scholarly journals Left ventricular myocardial performance index in prediabetic patients without coronary artery disease

2021 ◽  
Vol 33 (1) ◽  
Author(s):  
Hossam Eldin M. Mahmoud ◽  
Mohamed Alsenbesy ◽  
Gehad Osama Fawzy Sayed ◽  
Abdulla Eliaw Mohamed Ali ◽  
Ahlam M. Sabra
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Performance Index ◽  
Left Ventricular ◽  
Myocardial Performance Index ◽  
Control Group ◽  
Lv Function ◽  
Myocardial Performance ◽  
Artery Disease ◽  
Ventricular Ejection Time

Abstract Background Prediabetes is considered a major risk factor for diabetes mellitus (DM), leading to microvascular and cardiovascular disorders. Myocardial performance index (MPI) is a non-invasive Doppler method for the determination of global ventricular activity. We have not enough knowledge about the effect of prediabetes on the left ventricular (LV) function. We aimed to assess the MPI in prediabetic patients without coronary artery disease (CAD) utilizing echocardiography tissue Doppler imaging (TDI). Results We conducted a randomized controlled study that included fifty prediabetic patients and fifty healthy participants as the control group. All the participants were subjected to laboratory tests and echocardiography TDI to evaluate the LV systolic and diastolic functions We found that the isovolumic relaxation time (IVRT) and MPI values were significantly increased in the prediabetic patients compared to the control group (P < 0.001). In contrast, left ventricular ejection time (ET) was significantly longer in the control group than in prediabetic patients. Conclusion Prediabetes may adversely affect the LV function as assessed by MPI. Screening for prediabetes and early intervention is required for the prevention of cardiovascular morbidity and mortality.

scholarly journals Fetal myocardial index during labor

2016 ◽  
Vol 6 (1) ◽  
pp. 50-55 ◽  
Author(s):  
Alexis C. Gimovsky ◽  
Brianne Whitney ◽  
Dennis Wood ◽  
Stuart Weiner
Keyword(s):  
Performance Index ◽  
Fetal Echocardiography ◽  
Myocardial Performance Index ◽  
University Hospital ◽  
Myocardial Performance ◽  
Third Trimester ◽  
Ejection Time ◽  
Cervical Dilation ◽  
Non Invasive ◽  
Systolic And Diastolic Function

Abstract BACKGROUND: The Myocardial Performance Index (MPI) is a Doppler derived myocardial function tool and can be used to evaluate systolic and diastolic function in fetuses. The objectives of this study were to investigate the MPI during labor and compare it to values in non-laboring women. METHODOLOGY: 40 women with uncomplicated, term, singleton pregnancies were recruited to this prospective observational study at Thomas Jefferson University Hospital. Controls were a retrospective cohort of women > 34 weeks who underwent third trimester fetal echocardiography. Fetal left and right sided isovolumic contraction time, isovolumic relaxation time and ejection time were recorded before, during and after contractions. Right and left sided MPI was then calculated. RESULTS: Laboring patients and non-laboring patients were comparable for age, race, gravidity and parity. During labor the average left MPI was 0.63 ± 0.17 and the average right MPI was 0.62 ± 0.20. The coefficient of correlation between MPI and cervical dilation was 0.15 for left MPI Index and 0.14 for right MPI. When comparing non-laboring to laboring women, the average left MPI for non-laboring women was 0.34 ± 0.04, p = <0.001. CONCLUSIONS: Myocardial Performance Index is a non-invasive, easily attainable measure of cardiac function that can be obtained during labor and does not change with cervical dilation. MPI is significantly different between laboring and non-laboring women. The fetal MPI may help define fetal status in labor.

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