Antegrade late diastolic arterial blood flow in the fetus: Insight into fetal atrial function

Lisa W. Howley, Yuka Yamamoto, Sven Erik Sonesson, Priya Sekar, Venu Jain, Tarek Motan, Winnie Savard, Brandie D. Wagner, Jean Trines, Lisa K. Hornberger

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


Objective: The purpose of this study was to examine the presence and frequency of antegrade late diastolic arterial blood flow (ALDAF) in the fetus and to determine its contribution to cardiac output. Study Design: We evaluated the presence of ALDAF in 457 fetal and 21 postnatal echocardiograms. The timing of ALDAF to the ventricular systolic Doppler recording (ALDAF-V) was compared with the mechanical atrioventricular interval and, in neonates, the electrical PR interval. Velocity time integrals of ALDAF and the ventricular systolic Doppler signals were measured, and the percent contribution of ALDAF was calculated. Results: ALDAF was observed in 365 of 457 studies and included all <11 weeks' gestations. Strong correlation between ALDAF-V, atrioventricular interval, and electrical PR interval suggests that ALDAF coincides with atrial contraction. ALDAF contributed substantially to cardiac output in early gestation with later decline. Conclusion: ALDAF results from atrial contraction. Increasing gestational age results in less ALDAF, and reduced ALDAF contribution to cardiac output likely due to improved diastolic function.

Original languageEnglish (US)
Pages (from-to)490.e1-490.e8
JournalAmerican journal of obstetrics and gynecology
Issue number6
StatePublished - Jun 2013
Externally publishedYes


  • cardiac output
  • fetal echocardiography
  • first trimester

ASJC Scopus subject areas

  • Obstetrics and Gynecology


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