Abstract:
:A longitudinal study was performed in nine nonhydropic and nine hydropic fetuses with supraventricular tachycardia (SVT). First, because of a lack of reference methods in utero, the validity of spatial (length and area) and temporal parameters for semiquantitative grading of atrioventricular (AV) valve regurgitation by color Doppler flow mapping and M-Q mode imaging was evaluated by a longitudinal intraindividual study before and after drug-induced cardioversion to sinus rhythm and by correlation with the severity of hydrops and the time required for complete remission of hydrops. Second, with the demonstration of AV valve incompetence and changes in venous blood flow velocity wave forms, new data were collected concerning chronic SVT in the fetus. AV valve incompetence occurred in eight fetuses: during SVT only in three severely hydropic fetuses, during sinus rhythm in one nonhydropic fetus, and in seven hydropic fetuses including those previously mentioned, where AV incompetence outlasted tachycardia. The length and area of the regurgitant jet as imaged by color Doppler flow mapping and the temporal duration of regurgitation in relation to the systolic phase as measured by M-Q mode continuously diminished intraindividually but with great interindividual differences in the time span required for complete remission, which ranged from 5 to 42 days. Pulsed-wave Doppler studies of blood flow in the inferior vena cava and left hepatic vein demonstrated normal biphasic forward flow with a systolic and a diastolic surge during sinus rhythm in all fetuses and in two instances also during SVT of 190 and 195 beats/min, respectively. In all cases a pulsatile reversal of blood flow with systolic forward flow and diastolic reverse flow was observed during tachycardia greater than 220 beats/min. Thus the presence of functional AV valve incompetence as a result of annular enlargement seems to be a sign of SVT-induced "cardiomyopathy" during fetal life. AV valve incompetence during SVT was always associated with extremely severe hydrops and seemed to indicate the most severe degree of ventricular dysfunction, which could influence the selection of antiarrhythmic drugs. After termination of SVT, severe AV valve insufficiencies also occurred in other cases of hydrops, probably because of the markedly increased diastolic filling distending the already enlarged annular ring. The observed great interindividual differences in time required for disappearance of AV valve incompetence and hydrops could be explained by a different state of progression of tachycardia-induced "cardiomyopathy" at the time of drug-induced cardioversion.(ABSTRACT TRUNCATED AT 400 WORDS)
journal_name
Am Heart Jjournal_title
American heart journalauthors
Gembruch U,Redel DA,Bald R,Hansmann Mdoi
10.1016/0002-8703(93)90997-nsubject
Has Abstractpub_date
1993-05-01 00:00:00pages
1290-301issue
5 Pt 1eissn
0002-8703issn
1097-6744pii
0002-8703(93)90997-Njournal_volume
125pub_type
杂志文章abstract::In the United States there has been a dramatic decrease in age-adjusted coronary heart disease (CHD) mortality during the last 20 years. This article investigates the reasons for this decline and concludes that most of the decline in CHD has been the result of life-style changes, particularly reduction in serum choles...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/s0002-8703(05)80054-7
更新日期:1990-03-01 00:00:00
abstract::A case with total intra-His bundle block and intermittent pre-excitation syndrome is presented. During A-V conduction there was a P-delta interval of 130 msec. with a P-A interval of 20 msec., an A-H interval of 60 msec. and an H-V interval of 50 msec. During rapid atrial pacing the P-delta interval increased primaril...
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pub_type: 杂志文章
doi:10.1016/s0002-8703(77)80350-5
更新日期:1977-07-01 00:00:00
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pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2019-09-01 00:00:00
abstract:BACKGROUND:A substantial percentage of patients have undiagnosed diabetes. We investigated the demographic characteristics and cardiometabolic profiles of subjects with undiagnosed diabetes. METHODS:A cross-sectional study with nationally representative samples of 25490 subjects aged ≥ 20 years from the KHNANES 2008 t...
journal_title:American heart journal
pub_type: 杂志文章,多中心研究
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更新日期:2015-10-01 00:00:00
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doi:10.1016/0002-8703(93)90929-4
更新日期:1993-09-01 00:00:00
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doi:10.1016/0002-8703(84)90675-6
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pub_type: 临床试验,杂志文章,meta分析
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更新日期:2003-04-01 00:00:00
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pub_type: 杂志文章,多中心研究
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pub_type: 杂志文章,随机对照试验
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更新日期:2016-05-01 00:00:00
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更新日期:2002-02-01 00:00:00
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pub_type: 杂志文章
doi:10.1016/0002-8703(91)90723-u
更新日期:1991-02-01 00:00:00
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pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ahj.2007.07.036
更新日期:2007-11-01 00:00:00
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pub_type: 评论
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更新日期:2004-04-01 00:00:00
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pub_type: 杂志文章
doi:10.1016/0002-8703(88)90159-7
更新日期:1988-10-01 00:00:00
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更新日期:1981-06-01 00:00:00
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pub_type: 杂志文章
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pub_type: 杂志文章,随机对照试验
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更新日期:2008-12-01 00:00:00
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doi:10.1067/mhj.2001.109946
更新日期:2001-02-01 00:00:00
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更新日期:1987-07-01 00:00:00
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pub_type: 杂志文章
doi:10.1067/mhj.2000.110288
更新日期:2000-11-01 00:00:00
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更新日期:1986-04-01 00:00:00
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更新日期:2005-05-01 00:00:00
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pub_type: 杂志文章
doi:10.1016/s0002-8703(05)80010-9
更新日期:1990-02-01 00:00:00
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pub_type: 杂志文章
doi:10.1016/0002-8703(93)90162-3
更新日期:1993-03-01 00:00:00
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pub_type: 杂志文章
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更新日期:1984-05-01 00:00:00
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pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2021-01-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章,meta分析
doi:10.1016/j.ahj.2006.01.007
更新日期:2006-08-01 00:00:00
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pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.ahj.2009.07.022
更新日期:2009-10-01 00:00:00