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Updated: Jul 8, 2025
Murine Fetal Echocardiography
Published on: February 15, 2013
Left atrial strain in fetal echocardiography - could it be introduced to everyday clinical practice?
Edin Medjedovic1,2, Zijo Begic3, Milan Stanojevic4
1Clinic of Gynecology and Obstetrics, Clinical Center University of Sarajevo, Sarajevo, Bosnia and Herzegovina.
Insights
Left atrial strain (LAS) measured via fetal echocardiography is a feasible tool for prenatal screening of fetal heart conditions. This technique shows potential for predicting and guiding interventions for cardiac and noncardiac complications during pregnancy.
Area of Science:
- Cardiology
- Prenatal Medicine
- Medical Imaging
Background:
- Prenatal cardiology utilizes fetal echocardiography and interventional cardiology to manage congenital heart defects (CHD).
- Early detection of fetal CHD is crucial for appropriate perinatal care referral.
- Left atrial strain (LAS) is explored for its role in prenatal evaluation and prediction of fetal heart disorders.
Approach:
- A comprehensive literature review was conducted using PubMed up to August 2023.
- Search terms included "left atrial strain", "fetal echocardiography", and "prenatal cardiology".
- Reference lists of identified articles were also reviewed.
Key Points:
- LAS parameters in fetal echocardiography are significant screening tools, particularly between 11-14 and 18-22 weeks of gestation.
- LAS effectively identifies cardiac complications and predicts/guides interventions for fetal cardiac and noncardiac issues.
- Establishing second-trimester reference strain and strain rate values in healthy fetuses is vital for evaluating myocardial pathologies.
Conclusions:
- Measuring left atrial strain in fetal hearts is achievable.
- LAS holds potential clinical and prognostic value in prenatal cardiology.
Objectives:
Prenatal cardiology is a part of preventive cardiology based on fetal echocardiography and fetal interventional cardiology, which facilitates treatment of congenital heart defects (CHD) in pediatric patients and consequently in adults. Timely prenatal detection of CHD plays a pivotal role in facilitating the appropriate referral of pregnant women to facilities equipped to provide thorough perinatal care within the framework of a well-structured healthcare system. The aim of this paper is to highlight the role of left atrial strain (LAS) in prenatal evaluation of fetal heart and prediction of structural and functional disorders.
Methods:
We conducted a comprehensive literature review searching PubMed for articles published from inception up until August 2023, including the search terms "left atrial strain", "fetal echocardiography", and "prenatal cardiology" combined through Boolean operators. In addition, references lists of identified articles were further reviewed for inclusion.
Results:
Our review underscores the significance of LAS parameters in fetal echocardiography as a screening tool during specific gestational windows (starting from 11 to 14 weeks of gestation, followed by better visualization between 18 and 22 weeks of gestation). The left atrial strain technique and its parameters serve as valuable indicators, not only for identifying cardiac complications but also for predicting and guiding therapeutic interventions in cases of both cardiac and noncardiac pregnancy complications in fetuses. Evidence suggests establishment of second-trimester reference strain and strain rate values by speckle-tracking echocardiography in the healthy fetal cohort is essential for the evaluation of myocardial pathologies during pregnancy.
Conclusions:
Finding of LAS of fetal heart is feasible and probably can have potential for clinical and prognostic implications.
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