Tei Index Assessed By Pulse Wave Doppler Imaging In Normal Fetuses And Newborns

Objective: To assess the value of Tei index in evaluating the function of left and right ventricle during late pregnancy and neonatal period.Method: 1 Research object The study included all cases about 170 fetus during middle and late pregnancy between March 2017 and February 2018 from Xingtai People's Hospital.Data from Outpatient visits and hospitalization,echocardiography.The age of pregnant women is 20 to 45 years old,and the gestational weeks is 22 to 40 weeks.They are divided into 5 groups according to gestational weeks: 22~23weeks(n=31),24~27weeks(n=26),28~31weeks(n=33),32~36weeks(n=43),37~40 weeks(n=37).Grouping according to the fetal heart rate: 120~130 beats/min,131~140 beats/min,141~150beats/min,150~160 beats/min.A total of 70 fetuses at 32~40 weeks were selected from the subjects mentioned above.Tracking measurement of Tei indexes of left and right ventricle were conducted after birth.2 Instruments and Methods 2.1 Prenatal period Using Samsung SAMSUNG WS80 A color Doppler ultrasound diagnostic device,convex array probe CA1-7A,with probe frequency 1~7MHz,using pulse Doppler to continuously acquire 3 spectrum waveforms,take the mean,and measure the isovolumic contraction time(ICT)Isovolumic relaxation time(IRT)and ejection time(ET).Calculate left and right ventricle Tei index =(ICT+IRT)/ET=(a-b)/b,analyze Tei index of fetal left and right ventricle and gestational weeks(22~23w,24~27w,28~31w,32~36w,37~40w),the relationship between fetal heart rate(120~130 beats/min,131~140 beats/min,141~150 beats/min,150~160 beats/min),and summarizes the left ventricular Tei index Right Ventricular Tei Index The correlation between the two.2.2 The neonatal period Using our portable ultrasonic diagnostic instrument Mindray M5,P10-4s probe with a frequency of 2.5~5.5 MHz to perform a bedside neonatal heart examination.using pulsed Doppler imaging technique with same measurement method as the fetal period,to conduct accurate measurements for the ICT ET and IRT of left and right ventricular.Analyze the relationship of the Tei index of left and right ventricle between the neonatal and the fetal(32~36w,37~40w).3 Statistic analysis All statistical analyses were performed using SPSS version 18.0 for Microsoft Windows.All data were expressed as the means±tandard deviation(mean±SD).One-way ANOVA was used to determine variance of different gestational age groups and different heart rate ventricular Tei index.Paired t-test was used to determine the differences between the two groups.correlation analysis was used to determine the Tei index of fetal left and right ventricular(P<0.05)was considered to indicated stat-istically significant differences.4 Research results 4.1 Comparison of left and right ventricular Tei indexes in normal fetuses with different gestational weeks.Incorporating five fetal gestational age group analysis,(the mean±1.96 standard deviations).The left and right ventricular Tei index 95% medical reference ranges were(0.390±0.046)and(0.403±0.066)respectively.Five gestational age group of fetal left and right ventricular Tei index between two comparison,there was no statistically significant difference(P>0.05),the pregnancy 22~23w,24~27w,28~31w,32~36w,37~40w fetal left ventricular Tei index were 0.381±0.049,0.390±0.049,0.397±0.050,0.391±0.039 and 0.395±0.067.The right ventricular Tei index was 0.403±0.054,0.405±0.073,0.415±0.068,0.403±0.056 and 0.403±0.066. 4.2 Comparison between fetal left and right ventricular Tei indexes.Different gestational age groups of fetal left and right ventricular Tei index comparison,gestational age is 22~23w,24~27w,28~32w,36~31w fetal right ventricular Tei index is slightly higher than that of the left ventricle,gestational age is 37 to 40 w fetal left ventricular Tei index is slightly higher than that of the right ventricle,but Tei index differenc e between left and right ventricle has no statistical significance(P>0.05)Comparison of different gestational age groups of fetal left and right ventricular Tei index,gestational age is 22~23w,24~27w,28~32w,36~31w fetal right ventricular Tei index is higher than that of the left ventricle,gestational age is 37 to 40 w fetal left ventricular Tei index is higher than that of the right ventricle,but Tei index difference between left and right ventricle has no statistical significance(P>0.05)4.3 Comparison of left and right ventricular Tei indexes in normal fetus es with different heart rates.Compared with the left and right ventricular Tei index at the rate of discrepancy,there was no significant difference in heart rate between120~130 times/min group,heart rate 131~140/min group,heart rate 141~150/min group and heart rate /min group(P<0.05).4.4 The correlation between fetal period and neonatal period left and right ventricular Tei index.Postpartum follow-up was performed on 32~36w and 37~40w fetuses,the left ventricular Tei index of postpartum and neonatal(0.441±0.064)compared with right ventricular Tei index(0.389±0.019),the differe nce hasstatistical significance(P<0.05).Compared with the fetal phase,the left and right ventricle ICT+IRT,ET and Tei indexes in neonatal period were higher,but the difference was no statistical significance(P>0.05).Conclusion: As a reliable index of ventricular systolic and diastolic function,Tei index is a simple,high repeatable,high accurate and unaffected by the effects of ventricular geometric morphology,fetal heart rate and gestational age.It is an ideal method to evaluate the ventricular function of the fetus.It is of clinical use and promotion value.