Department of Obstetrics and Gynecology 'L. Mangiagalli', Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy.
Ultrasound Obstet Gynecol. 2014 Mar;43(3):284-90. doi: 10.1002/uog.13192. Epub 2014 Jan 1.
To examine the contraction time and relaxation time of the right ventricle at 11-13 weeks' gestation in trisomy 21 and euploid fetuses by speckle tracking ultrasound imaging.
Measurement of fetal nuchal translucency (NT) thickness, Doppler assessment for tricuspid regurgitation and reversed A-wave in the ductus venosus (DV) and fetal echocardiography were performed immediately before chorionic villus sampling for fetal karyotyping at 11-13 weeks' gestation. Digital videoclips of the four-chamber view of the fetal heart were recorded and analyzed offline using speckle tracking imaging software. The contraction time, which is the time between the highest and lowest peaks in the right ventricular area, and relaxation time, which is the time between the lowest and the subsequent highest area peak, were measured and expressed as a percentage of the duration of the cardiac cycle. Values in trisomy 21 and euploid fetuses were compared.
Mean contraction time and relaxation time in 119 euploid fetuses were 52.1% (95% CI, 51.6-52.8%) and 47.8% (95% CI, 47.2-48.4%), respectively. In 21 trisomy 21 fetuses, mean contraction time was significantly higher (57.0% (95% CI, 55.2-58.9%); P<0.01) and relaxation time lower (42.9% (95% CI, 41.1-44.8%); P<0.01) than in euploid fetuses. Multiple regression analysis showed that significant contributions to contraction time and relaxation time were provided by fetal karyotype, NT and tricuspid regurgitation, but not by reversed A-wave in the DV or the presence of a cardiac defect.
In first-trimester fetuses with trisomy 21 and in euploid fetuses with increased NT and tricuspid regurgitation there is evidence of increased right ventricular contraction time and shortening of the relaxation time.
通过斑点追踪超声成像技术，检测 21 三体和整倍体胎儿 11-13 孕周右心室的收缩时间和舒张时间。
在 11-13 孕周行胎儿颈项透明层（NT）厚度测量、三尖瓣反流及静脉导管（DV）反向 A 波多普勒评估，并在绒毛活检行胎儿染色体核型分析前即刻行胎儿超声心动图检查。记录胎儿心脏四腔心切面的数字视频片段，并离线使用斑点追踪成像软件进行分析。收缩时间为右心室面积最高点和最低点之间的时间，舒张时间为最低点和随后的最高点之间的时间，测量并表示为心动周期持续时间的百分比。比较 21 三体和整倍体胎儿的数值。
119 例整倍体胎儿的平均收缩时间和舒张时间分别为 52.1%（95%CI，51.6-52.8%）和 47.8%（95%CI，47.2-48.4%）。21 例 21 三体胎儿的收缩时间明显升高（57.0%（95%CI，55.2-58.9%）；P<0.01），舒张时间缩短（42.9%（95%CI，41.1-44.8%）；P<0.01），与整倍体胎儿相比。多元回归分析显示，收缩时间和舒张时间的主要影响因素是胎儿核型、NT 和三尖瓣反流，而不是 DV 反向 A 波或心脏缺陷的存在。
在 21 三体的胎儿和 NT 增加及三尖瓣反流的整倍体胎儿中，右心室收缩时间延长，舒张时间缩短。
