Relationship between Intracardiac Echogenic Focus and Fetal Cardiac Anomaly

Öz

Objective: The significance of intracardiac echogenic focus (ICEF) in the fetal period is controversial. We conducted the current study to determine whether ICEF affects the risk of cardiac malformation or anomaly in the fetus.

Material and Methods: The characteristics of the fetus with 248 intracardiac echogenic foci referred to the pediatric cardiology department for fetal echocardiography between December-2016 and May-2019 were retrospectively analyzed. The number, location, size of ICEF and presence of structural cardiac anomaly were examined. For statistical analysis, χ2 or Fisher’s exact test was used.

Results: Cardiac anomaly was detected in 10 of 248 fetuses with ICEF. The prevalence of cardiac anomaly was 4%. The most common cardiac anomaly was ventricular septal defect. The most common location of the echogenic focus was left ventricular (LV) (84.3%), followed by biventricular (BV) (9.7%) and right ventricular (RV) placement of 6%. The prevalence of cardiac anomalies in fetuses with ICEF located in RV was significantly higher than those with ICEF with LV and BV (13.3% vs. 3.3% and 4.1%, respectively). 14.5% of all fetuses had more than one ICEF. There was no statistically significant difference between the presence of ICEF and maternal age (p = 0.87).

Conclusion: Cardiac structural anomalies were found more frequently in fetuses with ICEF, especially in the right ventricle. More research is needed to examine the histopathological features of fetal echogenic focus in the right ventricle.

Anahtar Kelimeler

• Echocardiography
• Fetal
• Intracardiac echogenic focus
• Congenital anomaly

İntrakardiyak Ekojenik Odak ve Fetal Kardiyak Anomali İlişkisi

Öz

Amaç: Fetal dönemde intrakardiyak ekojenik odağın (İKEF) önemi tartışmalıdır. İKEF’nin fetüste kardiyak malformasyon veya anomali riskini etkileyip etkilemediğini belirlemek için mevcut çalışma gerçekleştirildi.

Gereç ve Yöntemler: Aralık-2016 ile Mayıs-2019 tarihleri arasında çocuk kardiyoloji bölümüne fetal ekokardiyografi için yönlendirilen 248 intrakardiyak ekojenik odak saptanan fetüse ait özellikler retrospektif olarak incelendi. İKEF sayısı, yerleşim yeri, büyüklüğü, yapısal kardiyak anomali varlığı incelendi. İstatistiksel analiz için χ2 veya Fisher exact testi yapıldı.

Bulgular: İKEF’a sahip 248 fetüsün 10 unda kardiyak patoloji saptandı. Kardiyak anomali görülme prevelansı %4 olarak belirlendi. En sık tespit edilen kardiyak anomali ventriküler septal defektti. Ekojenik odağın yerleşimi en sık sol ventrikül (LV) (% 84.3) yerleşimli, ardından biventriküler (BV) (%9.7) yerleşimli ve 6 sağ ventrikül (RV) yereşimliydi. RV yerleşimli İKEF’si bulunan fetüslerde kardiyak anomali prevelansı LV ve BV yerleşimli İKEF bulunanlara göre anlamlı olarak yüksekti (sırasıyla % 13.3’e karşı %3.3 ve %4.1). Tüm fetüslerin %14.5’inde birden fazla İKEF vardı. İKEF varlığı ile anne yaşı arasında istatistiksel olarak anlamlı bir fark bulunmadı (p = 0.87).

Sonuç: Özellikle sağ ventrikülde İKEF’si olan fetüslerde daha sık kardiyak yapısal anomali tespit edildi. Sağ ventrikülde fetal ekojenik odağın histopatolojik özelliklerini incelemek için daha fazla araştırma yapılması gerekir.

Anahtar Kelimeler

• Ekokardiyografi
• Fetal
• İntrakardiyak ekojenik odak
• Konjenital anomali

Kaynakça

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