Quantitative evaluation of fetal ventricular function by speckle
tracking echocardiography
Abstract
Methods The study included 59 patients with normal fetal heart
structure, blood flow, and heart rhythm (fetal abnormality-negative
group) and 50 patients with abnormal fetal heart structure, blood flow,
and/or heart rhythm (fetal abnormality-positive group). aCMQ was
performed in both groups to obtain left and right ventricular
endocardial global longitudinal strain (GLSendo), mid-myocardial global
longitudinal strain (GLSmid), and epicardial global longitudinal strain
(GLSepi). Parameters between the two groups were compared and
correlation analyses performed. A deformation analysis was performed by
two trained observers, and reproducibility was assessed. Results The
fetal left ventricular and right ventricular global longitudinal strain
(LV-GLS and RV-GLS, respectively) decreased in a gradient from the
endocardium to the epicardium. LV-GLS and RV-GLS of all myocardial
layers were lower in the fetal abnormality-positive than -negative group
(all P<0.05). Correlation analysis showed that neither LV-GLS
nor RV-GLS was significantly correlated with gestational age in the
fetal abnormality-negative group (all P>0.05), whereas left
ventricular GLSendo, GLSmid, and GLSepi were negatively correlated with
gestational age in the fetal abnormality-positive group (r=−0.39 to
−0.44, all P<0.05). Repeatability testing showed that the
inter-observer and intra-observer intraclass correlation coefficients
for LV-GLS and RV-GLS in each myocardial layer were >0.75
(all P<0.001). Conclusions As a new speckle tracking
echocardiography tool, aCMQ has feasibility and repeatability in
evaluating myocardial deformation of the fetal ventricle. This technique
might provide helpful information on ventricular myocardial deformation
in fetal hearts with abnormal structure or rhythm for clinical guidance
in pregnancy.