The Study Of Cardiac Function Changes By Automatic Measurement Method Of Myocardial Performance Index In Fetuses With Hemogllobin Bart’s Disease

Objective: To discuss the application of myocardial performance index(MPI)automatic measurement technology assessment cardiac function in fetus with hemoglobin Bart’s disease,and analysis the clinical value of myocardial performance index,middle cerebral artery-peak systolic velocity(MCA-PSV)and cardiothoracic ratio(CTR)to assess the risk of fetuses in hemoglobin Bart’s disease.Methods: All the fetuses were performed with two-dimensional ultrasound and Doppler imaging.The following parameters were measured:MCA-PSV,CTR,MPI,ICT,IRT and ET.The fetuses that had the risk of hemoglobin Bart’s disease were done by the prenatal diagnosis for testing the thalassemia gene on the way of amniotic fluid or cord blood puncture.Results: 1 、 Normal fetal left ventricular MPI increases with the growth of the gestational age slightly(r = 0.256,P < 0.05);Fetal leftventricular MPI does not increas with the growth of the fetal heart rate(P> 0.05).2 、 The group of fetuses with hemoglobin Bart’s disease andα-thalassemia intermedia had significantly higher MPI compared to theα-thalassemia-1 and the normal control(P<0.05);3、The group of fetuses with hemoglobin Bart’s disease had higher MCA-PSV and CTR than theα-thalassemia-1 and the normal fetuses(P < 0.01).4 、The biggest area under the ROC curve is CTR in assessing the risk of hemoglobin Bart’s disease with fetal left ventricular MPI,MCA-PSV,CTR,and has the highest assessing value.The value of MCA-PSV is middling.The value of fetal left ventricular MPI is the minimum.5、When assessing the risk of fetuses with hemoglobin Bart’s disease,the sensitivity and the specificity of fetal left ventricular MPI is 66.67%,90.24% respectively.When fetal left ventricular MPI combining with MCA-PSV the sensitivity and the specificity was 47.62%,97.56% respectively in predicting homozygousα-thalassemia-1.When fetal left ventricular MPI combining with CTR the sensitivity and the specificity was 66.67%,99.19% respectively.Fetal left ventricular MPI,MCA-PSV and CTR combined the sensitivity and the specificity was 47.62%,100% respectively.Conclusions:(1)MPI automatic measurement method may be more simple and accurate,which could have a better reliability and repeatability.(2)Fetal left ventricular MPI increases with the growth of the gestational age slightly;MPI is not increasing with the increase of fetal heart rate.(3)The MPI of the fetuses with hemoglobin Bart’s disease is higher than the normal fetuses.MPI can be a significant index in evaluating heart function of the α-thalassemia major.(4)Fetal left ventricular MPI,MCA-PSV,CTR can predict homozygous α-thalassemia-1 as a safe,non-invasive andreliable indicators.CTR has the highest value.The value of MCA-PSV is middling.The value of fetal left ventricular MPI is the lowest.(5)Fetal left ventricular MPI、MCA-PSV and CTR combined could make the evaluation of hemoglobin Bart’s disease risk specificity of 100%.