Department of Obstetrics and Prenatal Medicine, University of Bonn, Germany.
Ultraschall Med. 2012 Dec;33(7):E293-E298. doi: 10.1055/s-0029-1246029. Epub 2011 Feb 3.
The aim of this study was to evaluate the correlation of feature-tracking-derived measurements of the left ventricular myocardium in healthy fetuses with gestational age.
The global and segmental longitudinal peak systolic strain, strain rate and velocity values of the left ventricular myocardium for each gestational age were assessed by a novel feature tracking technique in 150 healthy fetuses (gestational age range 13 - 39 weeks of gestation). The interobserver and intraobserver variability was analyzed.
The global longitudinal peak systolic velocity exhibited a segmental base to apex gradient (p < 0.001). From 13 to 39 weeks of gestation, the global and segmental longitudinal peak systolic velocities increased significantly throughout gestation (p < 0.001), while the global longitudinal peak systolic strain remained constant (p = 0.34) and the strain rate exhibited only a tendency to decrease (p = 0.045). The interobserver and intraobserver variability of the global LV peak systolic strain, strain rate and velocity was acceptable. The standard deviations of measurement error between the two observers were 2.5 %, 0.7 s (-1) and 0.5 cm/sec, respectively.
The global myocardial peak systolic velocities of the left ventricle increase with gestational age, while the global myocardial peak systolic strain and strain rate remained nearly constant throughout gestation. This novel angle-independent, noninvasive technique offers a new objective approach to quantify global and segmental fetal myocardial performance throughout gestation.
本研究旨在评估健康胎儿左心室心肌的特征追踪衍生测量值与胎龄的相关性。
通过一种新的特征追踪技术，对 150 例健康胎儿（胎龄范围为 13-39 周）的左心室心肌的整体和节段性纵向收缩峰值应变、应变率和速度值进行评估。分析了观察者间和观察者内的变异性。
整体纵向收缩峰值速度呈现从基底到心尖的节段性梯度（p<0.001）。从 13 周到 39 周，整体和节段性纵向收缩峰值速度在整个孕期显著增加（p<0.001），而整体纵向收缩峰值应变保持不变（p=0.34），应变率仅呈下降趋势（p=0.045）。整体左心室收缩峰值应变、应变率和速度的观察者间和观察者内的变异性可接受。两位观察者之间的测量误差的标准偏差分别为 2.5%、0.7s(-1)和 0.5cm/sec。
左心室整体心肌收缩峰值速度随胎龄增加而增加，而整体心肌收缩峰值应变和应变率在整个孕期几乎保持不变。这种新的角度独立、非侵入性技术为定量评估整个孕期胎儿整体和节段性心肌功能提供了一种新的客观方法。
