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Evaluation of tissue Doppler-derived myocardial performance index in fetuses with intracardiac echogenic focus

Abstract Objective: To compare cardiac function between fetuses with and without intracardiac echogenic foci (IEFs) by conventional echocardiography and tissue Doppler (TD) imaging. Methods: Fetuses having IEF and no additional cardiac or extracardiac anomaly between 20 and 28 weeks (median 22 weeks) of gestation (n = 61) were compared with healthy fetuses between 18 and 29 weeks (median 23 weeks) of gestation (n = 55). Pulmonary artery and aortic peak velocities, atrioventricular (AV) early diastole (E) and atrial contraction (A) velocities and E/A ratios were measured. TD-derived myocardial performance index (MPI) was also measured. Results: Tricuspid valve E/A ratios, which were 0.634 ± 0.07 versus 0.639 ± 0.06 (p = 0.697), mitral valve E/A ratios, which were 0.604 ± 0.08 versus 0.612 ± 0.07 (p = 0.600), aorta peak velocities, which were 0.709 ± 0.11 versus 0.697 ± 0.11 (p = 0.592) and pulmonary artery peak velocities, which were 0.699 ± 0.12 versus 0.694 ± 0.11 (p = 0.800) in the study and the control groups, respectively. TD-derived measurements in the study and control groups included tricuspid valve MPI, which were 0.452 ± 0.08 versus 0.473 ± 0.09 (p = 0.221) and mitral valve MPI values, which were 0.444 ± 0.1 versus 0.445 ± 0.09 (p = 0.965), respectively, and this difference was not statistically significant. Conclusion: An isolated IEF is not associated with abnormal cardiac function. We suggest that the presence of an isolated IEF should not be an indication for fetal cardiac function examination either with conventional Doppler or TD imaging techniques, unless there is a coexisting cardiac or extracardiac anomaly.