Miranda J O, Hunter L, Tibby S, Sharland G, Miller O, Simpson J M
Fetal Cardiology Unit, Evelina London Children's Hospital, London, UK.
Department of Paediatric Intensive Care, Evelina London Children's Hospital, London, UK.
Ultrasound Obstet Gynecol. 2017 May;49(5):623-629. doi: 10.1002/uog.15939.
To study myocardial deformation by speckle tracking echocardiography in fetuses with coarctation of the aorta (CoA) compared with gestational age-matched normal controls.
This was a retrospective study of 12 fetuses with postnatally confirmed CoA and 12 gestational age-matched controls seen at a tertiary fetal cardiology unit between January 2013 and July 2014. Two-dimensional speckle tracking in standard grayscale four-chamber view of the fetal heart was performed to assess left and right myocardial deformation. Global longitudinal strain, strain rate and velocities, and regional longitudinal strain were analyzed and compared with controls.
Median gestational age at echocardiography was 25 + 4 weeks. Fetuses with CoA presented with a narrower, but not shorter, left ventricle when compared with controls (mitral valve diastolic diameter, 5.90 vs 8.50 mm; P = 0.002; left ventricular diastolic length, 16.50 vs 18.50 mm; P = 0.05). Global longitudinal systolic strain (P = 0.004), systolic strain rate (P = 0.01) and diastolic strain rate (P = 0.004) of the left ventricle were significantly lower in fetuses with CoA compared with controls. Similar findings were observed for longitudinal systolic (P = 0.03) and diastolic (P = 0.01) velocities of the left ventricle. Right ventricular parameters were not different between groups.
Fetuses with CoA have lower left ventricular longitudinal systolic strain, systolic strain rate and diastolic strain rate when compared with gestational age-matched control fetuses. These differences in deformation might explain, at least in part, the cardiac asymmetry observed in fetuses with CoA. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd.
采用斑点追踪超声心动图研究主动脉缩窄（CoA）胎儿的心肌变形，并与孕龄匹配的正常对照进行比较。
这是一项回顾性研究，研究对象为2013年1月至2014年7月在一家三级胎儿心脏病科就诊的12例出生后确诊为CoA的胎儿和12例孕龄匹配的对照。在胎儿心脏标准灰阶四腔视图中进行二维斑点追踪，以评估左、右心肌变形。分析整体纵向应变、应变率和速度以及区域纵向应变，并与对照进行比较。
超声心动图检查时的中位孕龄为25+4周。与对照相比，CoA胎儿的左心室更窄，但并不更短（二尖瓣舒张直径，5.90对8.50mm；P=0.002；左心室舒张长度，16.50对18.50mm；P=0.05）。与对照相比，CoA胎儿左心室的整体纵向收缩应变（P=0.004）、收缩应变率（P=0.01）和舒张应变率（P=0.004）显著降低。左心室纵向收缩（P=0.03）和舒张（P=0.01）速度也有类似发现。两组之间右心室参数无差异。
与孕龄匹配的对照胎儿相比，CoA胎儿的左心室纵向收缩应变、收缩应变率和舒张应变率更低。这些变形差异可能至少部分解释了CoA胎儿中观察到的心脏不对称。版权所有©2016国际妇产科超声学会。由约翰·威利父子有限公司出版。
