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Original Paper

Understanding the Aortic Isthmus Doppler Profile and Its Changes with Gestational Age Using a Lumped Model of the Fetal Circulation

Garcia-Canadilla P.a, b · Crispi F.a, c · Cruz-Lemini M.a, c · Valenzuela-Alcaraz B.a, c · Rudenick P.A.b · Gratacos E.a, c · Bijnens B.H.b, d

Author affiliations

aFetal i+D Fetal Medicine Research Center, BCNatal - Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Deu), IDIBAPS, University of Barcelona, bPhysense, DTIC, Universitat Pompeu Fabra, cCenter for Biomedical Research on Rare Diseases (CIBER-ER), and dICREA, Barcelona, Spain

Related Articles for ""

Fetal Diagn Ther 2017;41:41-50

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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: April 19, 2015
Accepted: January 19, 2016
Published online: February 24, 2016
Issue release date: February 2017

Number of Print Pages: 10
Number of Figures: 6
Number of Tables: 1

ISSN: 1015-3837 (Print)
eISSN: 1421-9964 (Online)

For additional information: https://www.karger.com/FDT

Abstract

Objective: The aortic isthmus (AoI) blood flow has a characteristic shape with a small end-systolic notch observed during the third trimester of pregnancy. However, what causes the appearance of this notch is not fully understood. We used a lumped model of the fetal circulation to study the possible factors causing the end-systolic notch and the changes of AoI flow through gestation. Methods: A validation of the model was performed by fitting patient-specific data from two normal fetuses. Then, different parametric analyses were performed to evaluate the major determinants of the appearance of the end-systolic notch. The changes in the AoI flow profile through gestation were assessed. Results: Our model allows to simulate the AoI waveform. The delay in the onset of ejection together with the longer ejection duration of the right ventricle are the most relevant factors in the origin of the notch. It appears around 25 weeks of gestation and becomes more pronounced with advancing gestation. Discussion: We demonstrated that the end-systolic notch on the AoI flow occurs mainly as a result of a delayed and longer ejection of the right ventricle. Our findings improve the understanding of hemodynamic changes in the fetal circulation and the interpretation of clinical imaging.

© 2016 S. Karger AG, Basel


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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: April 19, 2015
Accepted: January 19, 2016
Published online: February 24, 2016
Issue release date: February 2017

Number of Print Pages: 10
Number of Figures: 6
Number of Tables: 1

ISSN: 1015-3837 (Print)
eISSN: 1421-9964 (Online)

For additional information: https://www.karger.com/FDT


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