Pulsed Doppler evaluation of the atrioventricular valves is standard in a fetal echocardiogram. In the normal fetal mitral and tricuspid valve waveforms, the E point, which reflects passive ventricular filling, is always lower in velocity than the A point, which reflects atrial contraction. In the setting of intrauterine growth retardation, the E and A point relationship may be reversed, with the E point displaying a higher velocity than the A point. It should be borne in mind, however, that improper Doppler interrogation angle may cause a pseudo-reversal of these 2 points. Therefore, meticulous attention should be paid to interrogation angle to avoid the potential of an erroneous diagnosis.
Tsyvian P , Malkin K, Wladimiroff JW: Assessment of mitral A-wave transit time to cardiac outflow tract and isovolumic relaxation time of left ventricle in the appropriate and small for gestational age human fetus. Ultrasound Med Biol1997;23(2):187–190.
2.
Harada K , Rice MJ, Shiota T, et al: Gestational age and growth related alterations in fetal right and left ventricular diastolic filling patterns. Am J Cardiol1997;79:173–177.
3.
Arduini D , Rizzo G, Romanini C: Fetal cardiac function in growth retardation, in Arduini D, Rizzo G, Romanini C (eds): Fetal Cardiac Function. New York, Parthenon, 1995, pp 91–100.
Rizzo G , Arduini D: Fetal cardiac function in intrauterine growth retardation. Am J Obstet Gynecol1991;165: 876–872.
7.
Miyague NI , Ghidini A, Fromberg R, Miyague LLT: Alterations in ventricular filling in small for gestational age fetuses. Fetal Diagn Ther1997;12:332–335.
