Per accedir als documents amb el text complet, si us plau, seguiu el següent enllaç: http://hdl.handle.net/10230/36986

Títol:	Understanding the aortic isthmus Doppler profile and its changes with gestational age using a lumped model of the fetal circulation
Autor/a:	Garcia Canadilla, Patricia; Crispi Brillas, Fàtima; Cruz-Lemini, Mónica; Valenzuela Alcaraz, Brenda; Rudenick, Paula A.; Gratacós Solsona, Eduard; Bijnens, Bart
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.
Abstract:	This study was partly supported by grants from Ministerio de Economia y Competitividad (ref. SAF2012-37196, TIN2014-52923-R); the Instituto de Salud Carlos III (ref. (PI11/01709, PI12/00801, PI14/00226) integrado en el Plan Nacional de I+D+I y cofinanciado por el ISCIII-Subdirección General de Evaluación y el Fondo Europeo de Desarrollo Regional (FEDER) “Otra manera de hacer Europa”; the 1 EU FP7 for research, technological development and demonstration under grant agreement VP2HF (no 611823); The Cerebra Foundation for the Brain Injured Child (Carmarthen, Wales, UK); Obra Social "la Caixa” (Barcelona, Spain); Fundació Mutua Madrileña and Fundació Agrupació Mutua (Spain) and AGAUR 2014 SGR grant nº 928 (Barcelona, Spain). P.G.C. was supported by the Programa de Ayudas Predoctorales de Formación en investigación en Salud (FI12/00362) from the Instituto Carlos III, Spain. M.C.L. and B.V.A. wish to express her gratitude to the Mexican National Council for Science and Technology (CONACyT, Mexico City, Mexico) for supporting her predoctoral stay at Hospital Clinic, Barcelona, Spain.
Matèries:	-Computational model -Aortic isthmus -Fetal circulation -Doppler
Drets:	© 2017 S. Karger AG, Basel ‘This is the peer-reviewed but unedited manuscript version of the following article: Garcia-Canadilla P, Crispi F, Cruz-Lemini M, Valenzuela-Alcaraz B, Rudenick PA, Gratacos E, Bijnens BH. Understanding the aortic isthmus Doppler profile and its changes with gestational age using a lumped model of the fetal circulation. Fetal Diagn Ther. 2017 February;41(1):41-50. The final, published version is available at http://dx.doi.org/10.1159/000444142
Tipus de document:	Article Article - Versió acceptada
Publicat per:	Karger (S. Karger AG)
Compartir:

Mostra el registre complet del document