The purpose of this study was to evaluate left and right ventricular diastolic function in fetuses with congenital heart disease as compared to normal fetuses. Hemodynamic data were obtained from echocardiograms of 40 fetuses with right heart obstructive and nonobstructive congenital heart lesions (CHD). These data were compared to a group of 57 healthy fetuses that were matched for gestational age and heart rate. Diastolic function was assessed by analysis of inflow velocities measured from mitral and tricuspid valves. A significant increase in A waves was observed in the group with right ventricular obstructive disease compared to the normal group (0.60 6 0.13 vs 0.54 6 0.11, p = .048). The mitral valve velocity time integral (VTI) of fetuses with obstructive right ventricular disease was significantly increased (0.085 6 0.019 vs 0.073 6 0.013, p = .023). The peak right atrial filling rate, calculated from measurements at the tricuspid valve, was significantly higher in the group with right ventricular obstructive disease as compared to the control (82.2 6 38.5 vs 65.5 6 24.7, p = .024). These data show an increase in late diastolic filling in the obstructed group, which suggests that fetuses with right ventricular obstructive lesions have decreased biventricular diastolic function compared to normal fetuses. The data also demonstrate that in right obstructed fetal hearts, diastolic ventricular dysfunction occurs in both the obstructed and unobstructed ventricle.
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