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Right and left ventricular long-axis function in the fetus using angular M-mode
J S Carvalho1, C O'Sullivan, E A Shinebourne
1Department of Fetal Cardiology, Royal Brompton Hospital, London, UK. j.carvalho@rbh.nthames.nhs.uk
Summary
Assessing fetal cardiac long-axis function is feasible using M-mode echocardiography with angle correction. This technique reveals coordinated valve ring movements, similar to adults, offering new insights into fetal heart function.
Area of Science:
- Cardiology
- Fetal Medicine
- Echocardiography
Background:
- Long-axis cardiac function is crucial for assessing myocardial performance.
- Conventional M-mode echocardiography assesses valve ring motion postnatally.
- Fetal position variability complicates traditional fetal echocardiography for long-axis assessment.
Purpose of the Study:
- To evaluate the feasibility of determining fetal right and left ventricular long-axis function.
- To adapt M-mode echocardiography for accurate fetal cardiac assessment.
Main Methods:
- Prospective pilot study involving 18 fetuses (17-29 weeks gestation).
- Utilized B-mode guided M-mode echocardiography with angular correction on stored four-chamber cineloops.
- Measured valve ring excursions relative to the cardiac apex retrospectively.
Main Results:
- Successfully obtained right and left ventricular long-axis recordings in most cases.
- Measured mean right ventricular excursion at 5.2 mm and left ventricular free wall excursion at 4.5 mm.
- Observed coordinated valve ring movements during systole and diastole, consistent with adult patterns.
Conclusions:
- Fetal long-axis function assessment is feasible with M-mode angle correction.
- Tricuspid and mitral valve excursions showed no significant clinical differences.
- This method provides a novel approach to studying fetal systolic and diastolic function.