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Updated: Apr 26, 2026
Transthoracic Speckle Tracking Echocardiography for the Quantitative Assessment of Left Ventricular Myocardial Deformation
Published on: October 20, 2016
Speckle tracking echocardiography in fetuses diagnosed with congenital diaphragmatic hernia
Philip DeKoninck1, Jan D'hooge, Tim Van Mieghem
1Fetal Medicine Unit, Department of Obstetrics and Gynecology, University Hospitals Leuven, Leuven, Belgium; Cluster Organ Systems, Department of Development and Regeneration, KU Leuven, Leuven, Belgium.
Insights
This study found no cardiac dysfunction in fetuses with congenital diaphragmatic hernia (CDH) using speckle tracking. Left CDH cases showed increased left ventricular strain, suggesting compensatory changes.
Area of Science:
- Perinatology
- Fetal Cardiology
- Medical Imaging
Background:
- Congenital diaphragmatic hernia (CDH) is a serious condition affecting fetal development.
- Cardiac function assessment in fetuses with CDH is crucial for understanding disease impact.
- Speckle tracking echocardiography offers advanced methods for evaluating fetal cardiac mechanics.
Purpose of the Study:
- To evaluate cardiac function in fetuses diagnosed with congenital diaphragmatic hernia (CDH).
- To utilize speckle tracking technology for assessing fetal cardiac contractility in CDH.
- To investigate potential cardiac dysfunction and its correlation with pulmonary hypoplasia in CDH fetuses.
Main Methods:
- A case-control study design comparing fetuses with CDH to anatomically normal controls.
- Speckle tracking software was employed to calculate ventricular peak longitudinal velocity, displacement, and strain.
- Pulmonary hypoplasia was quantified using the observed/expected lung-to-head ratio (O/E LHR).
Main Results:
- Thirty-eight fetuses with CDH were analyzed; image quality was sufficient in 83% of cases.
- Ventricular velocity and displacement showed regional differences, similar to controls.
- Fetuses with left CDH exhibited increased left ventricular strain compared to controls, with no correlation to O/E LHR. Right CDH showed no significant differences.
Conclusions:
- No overt cardiac dysfunction was detected in fetuses with CDH, even with concurrent hypoplasia.
- Increased left ventricular strain in left CDH fetuses may indicate compensatory mechanisms.
- Speckle tracking is a valuable tool for assessing subtle cardiac changes in fetal CDH.
Objective:
The aim of this study is to evaluate cardiac function in fetuses with congenital diaphragmatic hernia (CDH) using speckle tracking.
Method:
Case-control study assessed cardiac contractility in consecutive fetuses with CDH. Controls were anatomically normal fetuses, adjusted for gestational age. Speckle tracking software calculated ventricular peak longitudinal velocity, displacement and strain. Pulmonary hypoplasia was assessed using observed/expected lung-to-head ratio (O/E LHR).
Results:
Thirty-eight fetuses with CDH (29 left and nine right) were evaluated at a mean gestational age of 26.9 ± 2.5 weeks. In six fetuses, the acquired images were of insufficient quality (feasibility 83%). Velocity and displacement showed regional differences, as well as significant differences between the ventricular walls, similar to control fetuses. Strain measurements also demonstrated regional differences yet less uniformly arranged. In left CDH, we observed increased strain values in the left ventricle compared with controls (-18.7 ± 7.2 vs -15.1 ± 4.9). There was no correlation between strain values in the left ventricle and O/E LHR. In fetuses with right CDH, deformation analysis was not different from controls.
Conclusions:
In fetuses with CDH, no cardiac dysfunction could be detected despite the often concurrent hypoplasia of ipsilateral cardiac structures. In fetuses with left CDH, the decrease in ventricular size coincides with increased strain values in the free left ventricular wall.
