Department of Pediatric Cardiology and Congenital Heart Disease, Deutsches Herzzentrum München, Technische Universität München, Germany.
Eur J Obstet Gynecol Reprod Biol. 2012 Sep;164(1):10-4. doi: 10.1016/j.ejogrb.2012.05.013. Epub 2012 May 30.
Ultrasound-based tissue Doppler imaging has opened new perspectives for non-invasive quantification of global, as well as regional, myocardial function. We therefore studied fetal hearts using the "tracking method" in order to assess its feasibility and changes of fetal myocardial velocities throughout gestation.
In 89 healthy fetuses color-coded tissue Doppler echocardiography (TDE) was prospectively conducted for further offline-analysis of global and regional myocardial function of the basal segment. Maximum tissue velocities at systole (S), in the early filling phase of diastole (E) and during atrial contraction (A) were estimated from three consecutive cardiac cycles.
Within a selected time limit of 15 min, raw data acquisition was possible in 60 of the 89 fetuses (67%). From the stored samples, velocities of S, E and A-wave could be obtained in 76% with good reproducibility for septal and right wall velocities. During gestation all velocities increased but to a greater extent at the right and left ventricular wall compared to the interventricular septum. The A-wave velocity was higher than E-wave velocity in all basal segments. Throughout gestation, the increase in E-wave was higher, resulting in an increase of the E-wave/A-wave ratio.
Tissue Doppler echocardiography using the tracking method in fetal hearts is practical during routine clinical examination, but it is time consuming and requires highly experienced observers The knowledge of myocardial velocities in normal pregnancies is essential in detecting pathologies.
超声组织多普勒成像为无创定量评估整体和局部心肌功能开辟了新的视角。因此，我们使用“跟踪法”研究胎儿心脏，以评估其在整个妊娠期的可行性和胎儿心肌速度的变化。
在 89 例健康胎儿中，前瞻性地进行彩色组织多普勒超声心动图（TDE）检查，以进一步离线分析基底节段的整体和局部心肌功能。从三个连续的心动周期中估计收缩期（S）、舒张早期（E）和心房收缩期（A）的最大组织速度。
在 15 分钟的选定时间内，89 例胎儿中有 60 例（67%）可以获得原始数据采集。从存储的样本中，可以获得 76%的 S、E 和 A 波速度，并且间隔和右壁速度具有良好的可重复性。在整个妊娠期，所有速度都增加了，但右心室壁和左心室壁的增加幅度大于室间隔。所有基底段的 A 波速度均高于 E 波速度。在整个妊娠期，E 波的增加幅度更高，导致 E 波/A 波比值增加。
在常规临床检查中，使用跟踪法的胎儿组织多普勒超声心动图在实践中是可行的，但它耗时且需要经验丰富的观察者。了解正常妊娠期间的心肌速度对于检测病理非常重要。
