{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T08:48:27Z","timestamp":1775465307104,"version":"3.50.1"},"reference-count":20,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2014,4,29]],"date-time":"2014-04-29T00:00:00Z","timestamp":1398729600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet & Gyne"],"published-print":{"date-parts":[[2014,6]]},"abstract":"ABSTRACT<\/jats:title>Objectives<\/jats:title>To assess the relationship between commonly reported fetal cardiomyopathy scoring systems in early\u2010stage twin\u2013twin transfusion syndrome (TTTS<\/jats:styled-content>)<\/jats:italic>.<\/jats:p><\/jats:sec>Methods<\/jats:title>We reviewed retrospectively 100 cases of Quintero Stages I and II TTTS<\/jats:styled-content> referred to our center for evaluation from 2008 to 2010. The cases were divided into groups of 25, representing each of four grades of TTTS<\/jats:styled-content> cardiomyopathy as assessed by Cincinnati stage: no cardiomyopathy, Stage IIIa<\/jats:styled-content>, Stage IIIb<\/jats:styled-content> and Stage IIIc<\/jats:styled-content>. Spearman correlation (<\/jats:italic>r<\/jats:italic>s<\/jats:sub>) was calculated between the Children's Hospital of Philadelphia (CHOP<\/jats:styled-content>) score, cardiovascular profile score (CVPS<\/jats:styled-content>), Cincinnati stage and myocardial performance index (MPI<\/jats:styled-content>)<\/jats:italic>.<\/jats:p><\/jats:sec>Results<\/jats:title>There was a weak correlation between the Cincinnati stage and the CHOP<\/jats:styled-content> score (<\/jats:italic>r<\/jats:italic>s<\/jats:sub>\u2009=\u20090.36) and CVPS<\/jats:styled-content> (<\/jats:italic>r<\/jats:italic>s<\/jats:sub>\u2009=\u2009\u22120.39), while correlation was strong between the CHOP<\/jats:styled-content> score and CVPS<\/jats:styled-content> (<\/jats:italic>r<\/jats:italic>s<\/jats:sub>\u2009=\u2009\u22120.72). MPI<\/jats:styled-content> elevation was concordant with Cincinnati stage more frequently (82% of cases) than were ventricular hypertrophy (43%) or atrioventricular valve regurgitation (28%). 51% of fetuses with minimally elevated CHOP<\/jats:styled-content> score (0\u20131) and 48% of fetuses with minimally depressed CVPS<\/jats:styled-content> (9\u201310) had significant elevation (<\/jats:italic>Z<\/jats:italic>\u2010score\u2009\u2265\u2009+3) in right ventricular or left ventricular MPI<\/jats:styled-content><\/jats:italic>.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>MPI<\/jats:styled-content> has a strong influence on grading the severity of fetal cardiomyopathy using the Cincinnati stage among fetuses with mild TTTS<\/jats:styled-content>. Furthermore, significant elevation of the MPI<\/jats:styled-content> is common among fetuses with mild disease as assessed by the CHOP<\/jats:styled-content> score and CVPS<\/jats:styled-content>. These differences should be understood when assessing and grading cardiomyopathy in TTTS<\/jats:styled-content>, particularly in early (Quintero Stages I and II<\/jats:styled-content>) disease. Copyright \u00a9 2013 ISUOG. Published by John Wiley & Sons Ltd<\/jats:italic>.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.13231","type":"journal-article","created":{"date-parts":[[2013,10,21]],"date-time":"2013-10-21T20:11:10Z","timestamp":1382386270000},"page":"646-651","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":29,"title":["Assessment of fetal cardiomyopathy in early\u2010stage twin\u2013twin transfusion syndrome: comparison between commonly reported cardiovascular assessment scores"],"prefix":"10.1002","volume":"43","author":[{"given":"C. R.","family":"Villa","sequence":"first","affiliation":[{"name":"Heart Institute Cincinnati Children's Hospital Medical Center Cincinnati OH USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"Habli","sequence":"additional","affiliation":[{"name":"Fetal Care Center of Cincinnati Cincinnati OH USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J. K.","family":"Votava\u2010Smith","sequence":"additional","affiliation":[{"name":"Heart Institute Cincinnati Children's Hospital Medical Center Cincinnati OH USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J. F.","family":"Cnota","sequence":"additional","affiliation":[{"name":"Heart Institute Cincinnati Children's Hospital Medical Center Cincinnati OH USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F.\u2010Y.","family":"Lim","sequence":"additional","affiliation":[{"name":"Fetal Care Center of Cincinnati Cincinnati OH USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A. A.","family":"Divanovic","sequence":"additional","affiliation":[{"name":"Heart Institute Cincinnati Children's Hospital Medical Center Cincinnati OH USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Y.","family":"Wang","sequence":"additional","affiliation":[{"name":"Division of Biostatistics and Epidemiology Cincinnati Children's Hospital Medical Center Cincinnati OH USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E. C.","family":"Michelfelder","sequence":"additional","affiliation":[{"name":"Heart Institute Cincinnati Children's Hospital Medical Center Cincinnati OH USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2014,4,29]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.jp.7200292"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2012.10.880"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.placenta.2008.08.019"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000127881.34144.d8"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.5211"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2007.06.055"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0029-7844(98)00220-8"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.72.1.74"},{"key":"e_1_2_5_10_1","first-page":"S183","article-title":"Echocardiographic function in cases of twin\u2013twin transfusion syndrome","volume":"4","author":"Gembruch U","year":"1994","journal-title":"Ultrasound Obstet Gynecol"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.7488"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.semperi.2005.10.001"},{"key":"e_1_2_5_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2008.05.004"},{"key":"e_1_2_5_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.7713"},{"key":"e_1_2_5_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2004.09.015"},{"key":"e_1_2_5_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.10117"},{"issue":"400","key":"e_1_2_5_17_1","article-title":"Assessment of fetal cardiac function before and after therapy for twin\u2010to\u2010twin transfusion syndrome","volume":"200","author":"Van Mieghem T","year":"2009","journal-title":"Am J Obstet Gynecol"},{"key":"e_1_2_5_18_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000146896.20317.59"},{"issue":"279","key":"e_1_2_5_19_1","article-title":"Diastolic cardiac pathology and clinical twin\u2013twin transfusion syndrome in monochorionic\/diamniotic twins","volume":"205","author":"Moon\u2010Grady AJ","year":"2011","journal-title":"Am J Obstet Gynecol"},{"key":"e_1_2_5_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.5161"},{"key":"e_1_2_5_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2011.04.010"}],"container-title":["Ultrasound in Obstetrics & Gynecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fuog.13231","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/uog.13231","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,4]],"date-time":"2023-10-04T22:30:50Z","timestamp":1696458650000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1002\/uog.13231"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,4,29]]},"references-count":20,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2014,6]]}},"alternative-id":["10.1002\/uog.13231"],"URL":"https:\/\/doi.org\/10.1002\/uog.13231","archive":["Portico"],"relation":{},"ISSN":["0960-7692","1469-0705"],"issn-type":[{"value":"0960-7692","type":"print"},{"value":"1469-0705","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,4,29]]},"assertion":[{"value":"2013-10-15","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2014-04-29","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}