Assessment of long-axis ventricular function in the fetal heart with a tissue-tracking algorithm

Area of Science:

• Cardiology
• Fetal Medicine
• Medical Imaging

Background:

• Tissue-tracking echocardiography (TTE) enables quantitative assessment of myocardial function.
• Understanding fetal cardiac mechanics is crucial for assessing prenatal well-being.

Purpose of the Study:

• To evaluate the feasibility of TTE in fetuses.
• To establish reference values for fetal myocardial motion and deformation.
• To investigate changes in fetal cardiac properties throughout pregnancy.

Main Methods:

• Analysis of fetal four-chamber-view cineloops from 230 pregnant women.
• Determination of reference values for global longitudinal peak velocity (V), strain (S), strain rate (SR), and displacement (D) in fetal ventricles.
• Assessment of intraobserver variability and changes in parameters with gestational age.

Main Results:

• Significant increase in fetal ventricular motion parameters (V, D) with advancing gestational age.
• Statistically significant decrease in deformation parameters (S, SR) as pregnancy progresses.
• Right ventricle (RV) demonstrated higher diastolic velocity (V) and strain rate (SR) compared to the left ventricle (LV).

Conclusions:

• Increased fetal cardiac motion correlates with cardiac growth.
• Decreased deformation parameters suggest intrauterine adaptation mechanisms.
• Distinct diastolic function differences exist between fetal right and left ventricles, establishing a basis for TTE in fetal medicine.