{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2023,10,19]],"date-time":"2023-10-19T02:24:07Z","timestamp":1697682247241},"reference-count":30,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2015,10,16]],"date-time":"2015-10-16T00:00:00Z","timestamp":1444953600000},"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":[[2015,11]]},"abstract":"ABSTRACT<\/jats:title>Objectives<\/jats:title>To investigate changes in the cardiac axis (CAx<\/jats:styled-content>) within the cardiac cycle of normal fetuses and fetuses with congenital heart defects (CHD<\/jats:styled-content>).<\/jats:p><\/jats:sec>Methods<\/jats:title>This was a retrospective case\u2013control study in which stored videoclips of four\u2010chamber views from 527 prenatal ultrasound examinations performed at 18\u2009+\u20090 to 36\u2009+\u20096\u2009weeks of gestation were reviewed. Among the ultrasound scans included, 287 were of normal fetuses (controls) and 240 were of fetuses with CHD<\/jats:styled-content>. In each case, the CAx<\/jats:styled-content> was measured at end systole (just before the atrioventricular (AV<\/jats:styled-content>) valve opened) and at end diastole (just before the AV<\/jats:styled-content> valve closed). CAx<\/jats:styled-content> measurements of fetuses with CHD<\/jats:styled-content> were compared to those of controls.<\/jats:p><\/jats:sec>Results<\/jats:title>The mean CAx<\/jats:styled-content> in the control group was 45.9\u2009\u00b1\u20098.5\u00b0 at end systole and 38.3\u2009\u00b1\u20098.4\u00b0 at end diastole (P<\/jats:italic>\u2009<\u20090.001), resulting in an average difference of 7.6\u2009\u00b1\u20093.2\u00b0. The mean CAx<\/jats:styled-content> in fetuses with CHD<\/jats:styled-content> was 53.4\u2009\u00b1\u200917.8\u00b0 at end systole and 47.5\u2009\u00b1\u200917.3\u00b0 at end diastole (P<\/jats:italic>\u2009<\u20090.001), resulting in an average difference of 5.9\u2009\u00b1\u20096.3\u00b0. However, in some forms of CHD<\/jats:styled-content>, such as hypoplastic left heart syndrome and L\u2010transposition of the great arteries, the CAx<\/jats:styled-content> was greater at end diastole than at end systole, with a difference of more than 5\u00b0. In 21.3% of control fetuses, there was a CAx<\/jats:styled-content> shift within the cardiac cycle of \u2265\u200910\u00b0. Abnormal CAx<\/jats:styled-content> measured at end systole was strongly associated with CHD<\/jats:styled-content>.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>Measurement of the CAx<\/jats:styled-content> at end systole provides values that differ from those when measured at end diastole, in both normal fetuses and those with CHD<\/jats:styled-content>. We recommend that the CAx<\/jats:styled-content> be measured at end systole as a greater proportion of fetuses with CHD<\/jats:styled-content> and fewer normal fetuses have an abnormal CAx<\/jats:styled-content> at this stage compared to at end diastole. The occurrence of an abnormal CAx<\/jats:styled-content> and the CAx<\/jats:styled-content> shift within the fetal cardiac cycle depend on the type of CHD<\/jats:styled-content>. Copyright \u00a9 2014 ISUOG. Published by John Wiley & Sons Ltd.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.14768","type":"journal-article","created":{"date-parts":[[2014,12,16]],"date-time":"2014-12-16T09:59:52Z","timestamp":1418723992000},"page":"558-563","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Cardiac axis shift within the cardiac cycle of normal fetuses and fetuses with congenital heart defect"],"prefix":"10.1002","volume":"46","author":[{"given":"Y.","family":"Zhao","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Division of Maternal\u2010Fetal Medicine Eastern Virginia Medical School Norfolk VA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S.","family":"Abuhamad","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Division of Maternal\u2010Fetal Medicine Eastern Virginia Medical School Norfolk VA 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