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The relationship between systolic notch duration of right ventricular outflow tract Doppler flow spectrum and gestational age and pulmonary blood flow

Year: 2025

Type: article

Abstract: Background: Right ventricular outflow tract (RVOT) systolic notch of Doppler flow pattern is common in normal fetuses, but its relationship with gestational age (GA) and pulmonary hemodynamics remains unknown. The aim of this study was to evaluate the changes of RVOT systolic notch with GA, and the correlation with pulmonary blood flow (PBF). Methods: A total of 124 fetuses underwent detailed measurements of right ventricular function, pulmonary hemodynamics, and RVOT Doppler envelope characteristics during routine fetal echocardiography. The relationship between RVOT systolic notch and GA, and PBF, was analyzed. Results: RVOT systolic notch of Doppler flow pattern ('spike and dome' morphology) was observed in all the fetuses. Notch duration (r=0.726, P<0.0001), notch duration to R-R interval ratio (r=0.644, P<0.0001), and notch to dome duration ratio (r=0.628, P<0.0001) displayed a better correlation with GA than the other parameters of RVOT Doppler flow spectra. Notch to spike duration ratio (r=0.652, P<0.0001), notch duration (r=0.624, P<0.0001), and notch duration to R-R interval ratio (r=0.586, P<0.0001) all correlated well with PBF. The area under the receiver operating characteristic curve (AUC) of 0.872 for notch duration and that for notch duration to R-R interval ratio (0.824) were superior to those for notch to spike duration ratio (0.694) and notch to dome duration ratio (0.808) to differentiate between second- and third-trimester. The optimal cutoff value of notch duration was 132 milliseconds (ms), with a sensitivity of 82.50%, a specificity of 91.46%, and an accuracy of 88.52%. Conclusions: RVOT systolic notch parameters of Doppler flow pattern, especially notch duration, appears to be a promising ultrasonic biological indicator for the evaluation of fetal pulmonary vascular bed development.

Source: Quantitative Imaging in Medicine and Surgery

DOI: 10.21037/qims-2025-450

Authors: Li Xu, Jie Zhang, Jiangli Qiang, Xiaozhi Zheng

Institutions: Yangzhou University, Xuzhou Medical College, The First People’s Hospital of Lianyungang, Tongji University, Yangpu Hospital of Tongji University

Language: English

Topic: Congenital Heart Disease Studies

Subfield: Epidemiology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: diamond

OpenAlex ID: W4416455193

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