Prenatal diagnosis · 2026
Cardiovascular Profile Score and Perinatal Survival Among Fetuses With Ebstein's Anomaly or Tricuspid Valve Dysplasia: A Multi-Center Retrospective Cohort Study.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод в очереди
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Freire Grace, Thieu Nguyen, Diaz Maria Escobar, Komarlu Rukmini, Vernon Margaret M, Ikemba Catherine M, Michelfelder Erik C, Samai Cyrus, Kovalchin John P, Tworetzky Wayne, Huhta James, Wilhm Marilyn, Fierstein Jamie L, Freud Lindsay R
Аннотация
OBJECTIVE: We sought to perform multi-variable modeling to assess the independent value of the CVPS in fetuses with Ebstein anomaly or tricuspid valve dysplasia (EA/TVD).
METHODS: CVPS was assessed at a core lab using the first and last echocardiograms during gestation. A receiver operating characteristic (ROC) curve analysis was conducted. Changes in the CVPS from the first to the last echo were assessed with Wilcoxon signed-rank tests.
RESULTS: There were 164 fetuses with EA/TVD with complete CVPS at the first echo. Nearly half, 48.8% (n = 80), had intrauterine fetal demise (IUFD) or died neonatally. At the first echo, median gestational age (GA) was 27.6 weeks (IQR: 23.0-31.0) and median CVPS was 7 (IQR: 6-8). The optimal cut-point for classification of perinatal survival was observed at CVPS ≥ 6.5 (Youden index = 0.46). After adjustment, there remained a significant independent association between every 1-point increase in the CVPS at first echo and the odds of perinatal survival (adjusted odds ratio: 2.0, 95% CI: 1.3 to 3.2, and p = 0.003). The CVPS at the last echo decreased by a median of 1 point among both survivors (p < 0.01) and non-survivors (p < 0.001).
CONCLUSION: Among fetuses with EA/TVD, the CVPS may be used as an additional tool to assess perinatal survival throughout gestation.
METHODS: CVPS was assessed at a core lab using the first and last echocardiograms during gestation. A receiver operating characteristic (ROC) curve analysis was conducted. Changes in the CVPS from the first to the last echo were assessed with Wilcoxon signed-rank tests.
RESULTS: There were 164 fetuses with EA/TVD with complete CVPS at the first echo. Nearly half, 48.8% (n = 80), had intrauterine fetal demise (IUFD) or died neonatally. At the first echo, median gestational age (GA) was 27.6 weeks (IQR: 23.0-31.0) and median CVPS was 7 (IQR: 6-8). The optimal cut-point for classification of perinatal survival was observed at CVPS ≥ 6.5 (Youden index = 0.46). After adjustment, there remained a significant independent association between every 1-point increase in the CVPS at first echo and the odds of perinatal survival (adjusted odds ratio: 2.0, 95% CI: 1.3 to 3.2, and p = 0.003). The CVPS at the last echo decreased by a median of 1 point among both survivors (p < 0.01) and non-survivors (p < 0.001).
CONCLUSION: Among fetuses with EA/TVD, the CVPS may be used as an additional tool to assess perinatal survival throughout gestation.