Biventricular Coupling: Physiological Function, Anatomical Remodeling and Advances in Ultrasound Imaging

Area of Science:

• Cardiovascular Physiology
• Fetal Development
• Medical Imaging

Background:

• The fetal cardiovascular system is essential for development, with the heart maturing throughout gestation.
• Biventricular coupling is a key aspect of fetal cardiac function.
• Congenital heart disease (CHD) and ductus arteriosus abnormalities can impair fetal cardiac function.

Purpose of the Study:

• To review current understanding of fetal biventricular coupling.
• To explore advanced imaging and AI techniques for assessing fetal cardiac function.
• To highlight the pathophysiological basis of impaired biventricular coupling in fetal conditions.

Main Methods:

• Review of recent advances in ultrasound imaging (Doppler, TDI, 2D/3D speckle tracking).
• Discussion of emerging techniques like fetal heart quantification, multimodal imaging, and AI.
• Analysis of pathological changes affecting fetal cardiac structure and hemodynamics.

Main Results:

• Advanced imaging techniques enable comprehensive fetal cardiac assessment.
• Emerging technologies offer new perspectives on evaluating ventricular coupling.
• Pathological changes like CHD can lead to biventricular decoupling, mirroring adult mechanisms.

Conclusions:

• Impaired fetal biventricular coupling is linked to cardiac abnormalities and hemodynamic disturbances.
• Further research is needed to establish normal reference criteria for fetal biventricular coupling.
• Clarifying the correlation between biventricular coupling and perinatal outcomes is essential.