Elmstedt Nina Ne, Johnson Jonas Jj, Lind Britta Bl, Ferm-Widlund Kjerstin Kfw, Herling Lotta Lh, Westgren Magnus Mw, Brodin Lars-Åke Lab
Cardiovasc Ultrasound. 2013 Aug 16;11:29. doi: 10.1186/1476-7120-11-29.
Myocardial function can be evaluated using color-coded tissue velocity imaging (TVI) to analyze the longitudinal myocardial velocity profile, and by expressing the motion of the atrioventricular plane during a cardiac cycle as coordinated events in the cardiac state diagram (CSD). The objective of this study was to establish gestational age specific reference values for fetal TVI measurements and to introduce the CSD as a potential aid in fetal myocardial evaluation.
TVI recordings from 125 healthy fetuses, at 18 to 42 weeks of gestation, were performed with the transducer perpendicular to the apex to provide a four-chamber view. The myocardial velocity data was extracted from the basal segment of septum as well as the left and right ventricular free wall for subsequent offline analysis.
During a cardiac cycle the longitudinal peak velocities of septum increased with gestational age, as did the peak velocities of the left and right ventricular free wall, except for the peak velocity of post ejection. The duration of rapid filling and atrial contraction increased during pregnancy while the duration of post ejection decreased. The duration of pre ejection and ventricular ejection did not change significantly with gestational age.
Evaluating fetal systolic and diastolic performance using TVI together with CSD could contribute to increase the knowledge and understanding of fetal myocardial function and dysfunction. The pre and post ejection phases are the variables most likely to indicate fetuses with abnormal myocardial function.
可使用彩色编码组织速度成像（TVI）评估心肌功能，以分析心肌纵向速度剖面，并通过将心动周期中房室平面的运动表示为心脏状态图（CSD）中的协调事件来进行评估。本研究的目的是建立特定孕周的胎儿TVI测量参考值，并引入CSD作为胎儿心肌评估的潜在辅助手段。
对125例妊娠18至42周的健康胎儿进行TVI记录，将换能器垂直于心尖以获得四腔心视图。从室间隔基底部以及左、右心室游离壁提取心肌速度数据，以便后续离线分析。
在心动周期中，除射血后期峰值速度外，室间隔纵向峰值速度以及左、右心室游离壁峰值速度均随孕周增加。妊娠期间快速充盈期和心房收缩期持续时间增加，而射血后期持续时间减少。射血前期和心室射血期持续时间随孕周无显著变化。
使用TVI结合CSD评估胎儿的收缩和舒张功能，有助于增加对胎儿心肌功能和功能障碍的认识和理解。射血前期和射血后期是最有可能提示心肌功能异常胎儿的变量。
