{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T17:34:15Z","timestamp":1787506455275,"version":"build-2736575974"},"reference-count":47,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2018,1,3]],"date-time":"2018-01-03T00:00:00Z","timestamp":1514937600000},"content-version":"vor","delay-in-days":2,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"publisher","award":["PI12\/00801 and PI14\/00226"],"award-info":[{"award-number":["PI12\/00801 and PI14\/00226"]}],"id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp;amp; Gyne"],"published-print":{"date-parts":[[2018,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Recent data suggest that singleton fetuses conceived by assisted reproductive technology (ART) present cardiovascular remodeling that may persist postnatally. Twin pregnancies are more frequent in the ART population and are associated with increased adverse perinatal outcomes, such as hypertensive disorders, gestational diabetes and preterm birth. However, it is unknown whether cardiac remodeling is also present in twin pregnancies conceived by ART. Our aim was to assess the presence of fetal cardiac remodeling and dysfunction in twin pregnancies conceived by ART as compared with those conceived spontaneously (SC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This was a prospective cohort study including 50 dichorionic twin fetuses conceived by ART and 50 SC twin fetuses. The study protocol included collection of baseline\/perinatal data and a fetal ultrasound examination at 28\u201330\u2009weeks' gestation, including assessment of estimated fetal weight, fetoplacental Doppler and fetal echocardiography. Measurements of atrial area, atrial\/heart ratio, ventricular sphericity index, free wall thickness, mitral and tricuspid annular plane systolic excursions, and systolic and early diastolic peak velocities were assessed. Multilevel analyses were used to compare perinatal and ultrasonographic parameters. Comparisons of echocardiographic variables were adjusted for parental age, paternal body mass index and incidence of pre\u2010eclampsia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Compared with SC twins, ART twin fetuses showed significant cardiac changes, predominantly affecting the right heart, such as dilated atria (right atrial\/heart area: 15.7\u2009\u00b1\u20093.1\n                      <jats:italic>vs<\/jats:italic>\n                      18.4\u2009\u00b1\u20093.2,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&lt;\u20090.001), more globular ventricles (right ventricular sphericity index: 1.57\u2009\u00b1\u20090.25\n                      <jats:italic>vs<\/jats:italic>\n                      1.41\u2009\u00b1\u20090.23,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.001) and thicker myocardial walls (septal wall thickness: 2.57\u2009\u00b1\u20090.45\u2009mm\n                      <jats:italic>vs<\/jats:italic>\n                      2.84\u2009\u00b1\u20090.41\u2009mm,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.034) together with reduced longitudinal motion (tricuspid annular plane systolic excursion: 6.36\u2009\u00b1\u20090.89\u2009mm\n                      <jats:italic>vs<\/jats:italic>\n                      5.18\u2009\u00b1\u20090.93\u2009mm,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&lt;\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>ART twin fetuses present signs of cardiac remodeling and dysfunction. These changes are similar to those observed in ART singletons and reinforce the concept of fetal cardiac programing in ART. These results open opportunities for early detection and intervention in infants conceived by ART. Copyright \u00a9 2017 ISUOG. Published by John Wiley &amp; Sons Ltd.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/uog.17527","type":"journal-article","created":{"date-parts":[[2017,5,15]],"date-time":"2017-05-15T22:26:41Z","timestamp":1494887201000},"page":"94-100","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Fetal cardiac remodeling in twin pregnancy conceived by assisted reproductive technology"],"prefix":"10.1002","volume":"51","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3300-2120","authenticated-orcid":false,"given":"B.","family":"Valenzuela\u2010Alcaraz","sequence":"first","affiliation":[{"name":"BCNatal \u2010 Barcelona Center for Maternal\u2010Fetal and Neonatal Medicine (Hospital Cl\u00ednic and Hospital Sant Joan de Deu), Institut d'Investigacions Biom\u00e8diques August Pi i Sunyer (IDIBAPS) Universitat de Barcelona, and Centre for Biomedical Research on Rare Diseases (CIBER\u2010ER)  Barcelona Spain"},{"name":"Fetal Medicine Mexico, Fetal Medicine and Surgery Research Unit, Unidad de Investigaci\u00f3n en Neurodesarrollo, Instituto de Neurobiolog\u00eda Universidad Nacional Aut\u00f3noma de M\u00e9xico (UNAM) Campus Juriquilla  Quer\u00e9taro Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Cruz\u2010Lemini","sequence":"additional","affiliation":[{"name":"BCNatal \u2010 Barcelona Center for Maternal\u2010Fetal and Neonatal Medicine (Hospital Cl\u00ednic and Hospital Sant Joan de Deu), Institut d'Investigacions Biom\u00e8diques August Pi i Sunyer (IDIBAPS) Universitat de Barcelona, and Centre for Biomedical Research on Rare Diseases (CIBER\u2010ER)  Barcelona Spain"},{"name":"Fetal Medicine Mexico, Fetal Medicine and Surgery Research Unit, Unidad de Investigaci\u00f3n en Neurodesarrollo, Instituto de Neurobiolog\u00eda Universidad Nacional Aut\u00f3noma de M\u00e9xico (UNAM) Campus Juriquilla  Quer\u00e9taro Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Rodr\u00edguez\u2010L\u00f3pez","sequence":"additional","affiliation":[{"name":"BCNatal \u2010 Barcelona Center for Maternal\u2010Fetal and Neonatal Medicine (Hospital Cl\u00ednic and Hospital Sant Joan de Deu), Institut d'Investigacions Biom\u00e8diques August Pi i Sunyer (IDIBAPS) Universitat de Barcelona, and Centre for Biomedical Research on Rare Diseases (CIBER\u2010ER)  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Gonc\u00e9","sequence":"additional","affiliation":[{"name":"BCNatal \u2010 Barcelona Center for Maternal\u2010Fetal and Neonatal Medicine (Hospital Cl\u00ednic and Hospital Sant Joan de Deu), Institut d'Investigacions Biom\u00e8diques August Pi i Sunyer (IDIBAPS) Universitat de Barcelona, and Centre for Biomedical Research on Rare Diseases (CIBER\u2010ER)  Barcelona 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