How Does Right Atrial Function Differ? A Speckle-Tracking Echocardiographic Comparison of Fetuses With Left...

To evaluate the feasibility of two-dimensional speckle tracking echocardiography (2D-STE) for quantitatively assessing right atrial global longitudinal strain (RAGLS) in normal fetuses, and to compare RAGLS among normal fetuses, fetuses with left ventricular outflow tract obstruction (LVOTO), and those with moderate-to-severe tricuspid regurgitation (TR).

A total of 32 fetuses with LVOTO, 25 with moderate-to-severe TR, and 100 normal fetuses were enrolled. RAGLS was compared among the three groups, and its correlations with gestational age (GA) and other echocardiographic parameters were analyzed. Inter- and intra-observer repeatability was assessed using intraclass correlation coefficients (ICC) and Bland-Altman analysis.

RAGLS differed significantly among the three groups (p < 0.01). The RAGLS values in both the TR and LVOTO groups were significantly lower than those in the control group (both p < 0.01), whereas the LVOTO group exhibited significantly higher RAGLS compared to the TR group (p < 0.05). In the control group, RAGLS was negatively correlated with GA (r = -0.47, p < 0.01). However, in the TR or LVOTO groups, RAGLS showed no significant correlation with GA or other measured parameters (all p > 0.05). The inter- and intra-observer repeatability of RAGLS measurements was good (ICC > 0.75).

The right atrial reservoir function is impaired in fetuses with TR and those with LVOTO. RAGLS may serve as a sensitive indicator for quantitatively evaluating RA dysfunction in fetal cardiac anomalies.