Download files
Abstract
This thesis aimed to evaluate the human fetal cardiac function using the modified myocardial performance index (Mod-MPI) modality in normal and pathological pregnancies. The previously developed Mod-MPI has been applied in normal pregnancies and in a wide range of patholog. In my initial attempt to evaluate the method I could not achieve similar results with which has been published before. In a large cohort of pregnant patients I modified the technique by altering machine settings and I could determine the best settings and apply them in my experiments. Furthermore I highlighted areas of clinical significance in the evaluation of Mod-MPI that have not been evaluated before. This included detailed exploration of the morphology of both right and left Mod-MPI Doppler waveforms and the significance of the valve click appearance on the measurement of the time intervals as well as the calculated ModMPI. I also evaluated the reproducibility of the Mod-MPI of the right ventricle and compare it for the first time with the left.
I next developed the gestational age adjusted normal ranges in the Australian population of the right and left ModMPI based on three caliper positions defined in my established technique. I then evaluated the relationship between the right and left Mod-MPI (Delta Mod-MPI). I also evaluated the left Mod-MPI in a cohort of gestational diabetic others.
Despite there being a large number of international groups undertaking research in this area, I could achieve novel results and accordingly future research should be directed towards universal agreement in the methodology of the Mod-MPI before further application of the technique in pathology.