{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T00:49:20Z","timestamp":1792111760024,"version":"4.4.0"},"reference-count":40,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2021,2,1]],"date-time":"2021-02-01T00:00:00Z","timestamp":1612137600000},"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 &amp; Gyne"],"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The false\u2010positive rate for prenatal diagnosis of coarctation of the aorta (FP\u2010CoA) commonly exceeds 50%, with an accurate detection rate of &lt;\u200950%. This study was conducted to determine if the sensitivity for prenatal detection of true CoA and the FP\u2010CoA rate could be improved by evaluating the fetal epicardial size and shape in the four\u2010chamber view (4CV) and the endocardial right (RV) and left (LV) ventricular size, shape and contractility.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We analyzed retrospectively Digital Imaging and Communications in Medicine (DICOM) clips of the 4CV from the last examination prior to delivery in a series of 108 fetuses with CoA suspected prenatally by pediatric cardiologists using traditional diagnostic criteria. Postnatal evaluation distinguished those fetuses which subsequently required CoA surgery (true positives; true CoA) from those that were FP\u2010CoA. Postnatal cardiac abnormalities were identified for each group. For the prenatal evaluation, we measured the 4CV end\u2010diastolic epicardial area, circumference, length, width and global sphericity index. Speckle\u2010tracking analysis was used to compute the endocardial RV and LV end\u2010diastolic area, length, 24\u2010segment sphericity index, 24\u2010segment transverse width and the following functional parameters: fractional area change;  global longitudinal, free\u2010wall and septal\u2010wall strain; basal\u2013apical\u2010length, basal free\u2010wall and basal septal\u2010wall fractional shortening; septal\u2010wall annular plane systolic excursion; 24\u2010segment transverse\u2010width fractional shortening; and LV end\u2010diastolic and end\u2010systolic volumes, stroke volume, cardiac output and ejection fraction. In addition, the RV\/LV end\u2010diastolic area ratio was computed. Using a control group of 200 normal fetuses, the mean and SD for each of the above cardiac measurements was used to compute the\n                      <jats:italic>Z<\/jats:italic>\n                      \u2010scores for each measurement in each of the 108 study fetuses. Logistic regression analysis was then performed on the\n                      <jats:italic>Z<\/jats:italic>\n                      \u2010score values to identify variables that separated the true CoA group from the FP\u2010CoA group.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      Of the 108 study fetuses, 54 were confirmed postnatally to have true CoA and 54 were FP\u2010CoA. Right\/left area disproportion &gt;\u200990\n                      <jats:sup>th<\/jats:sup>\n                      \u2009centile was present in 80% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200943) of the true\u2010CoA fetuses and 76% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200941) of the FP\u2010CoA fetuses. Fetuses with true CoA had a significantly greater number of associated cardiac abnormalities (93%,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200950) compared with the FP\u2010CoA fetuses (61%,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200933) (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001). The most common associated malformations were bicuspid aortic valve (true CoA, 46% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200925)\n                      <jats:italic>vs<\/jats:italic>\n                      FP\u2010CoA, 22% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200912);\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.01), aortic arch hypoplasia (true CoA, 31% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200917)\n                      <jats:italic>vs<\/jats:italic>\n                      FP\u2010CoA, 11% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20096);\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.01), ventricular septal defect (true CoA, 33% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200918)\n                      <jats:italic>vs<\/jats:italic>\n                      FP\u2010CoA, 11% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20096);\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.05) and mitral valve abnormality (true CoA, 30% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200916)\n                      <jats:italic>vs<\/jats:italic>\n                      FP\u2010CoA, 4% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20092);\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.01). Logistic regression analysis identified 28 variables that correctly identified 96% (52\/54) of the fetuses with true CoA, with a false\u2010positive rate of 4% (2\/54) and a false\u2010negative rate of 4% (2\/54). These variables included the epicardial size in the 4CV, size and shape of RV and LV, and abnormal contractility of RV and LV. The area under the receiver\u2010operating\u2010characteristics curve was 0.98 (SE, 0.023; 95%\u2009CI, 0.84\u20131). There was no significant difference in the percent of fetuses with RV\/LV area disproportion between those with CoA and those that were FP\u2010CoA.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Speckle\u2010tracking analysis of multiple ventricular measurements may be helpful to refine the diagnosis in fetuses that are suspected to have CoA prenatally. \u00a9 2020 International Society of Ultrasound in Obstetrics and Gynecology<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/uog.21989","type":"journal-article","created":{"date-parts":[[2020,2,5]],"date-time":"2020-02-05T08:19:40Z","timestamp":1580890780000},"page":"282-291","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":53,"title":["Improved detection of coarctation of the aorta using speckle\u2010tracking analysis of fetal heart on last examination prior to delivery"],"prefix":"10.1002","volume":"57","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8814-572X","authenticated-orcid":false,"given":"G. R.","family":"DeVore","sequence":"first","affiliation":[{"name":"Division of Maternal\u2010Fetal Medicine, Department of Obstetrics and Gynecology David Geffen School of Medicine, UCLA  Los Angeles CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Haxel","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Pediatrics, Children's Hospital Colorado University of Colorado School of Medicine  Aurora CO USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.","family":"Satou","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology, Department of Pediatrics, UCLA Mattel Children's Hospital David Geffen School of Medicine at UCLA  Los Angeles CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Sklansky","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology, Department of Pediatrics, UCLA Mattel Children's Hospital David Geffen School of Medicine at UCLA  Los Angeles CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. J.","family":"Pelka","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology, Department of Pediatrics, UCLA Mattel Children's Hospital David Geffen School of Medicine at UCLA  Los Angeles CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P. N.","family":"Jone","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Pediatrics, Children's Hospital Colorado University of Colorado School of Medicine  Aurora CO USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9085-0882","authenticated-orcid":false,"given":"B. 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