Department of OB/GYN, Division of Prenatal Medicine, University Hospital UKGM, Justus-Liebig University, Giessen, Germany.
Department of OB/GYN, University Hospital Rechts der Isar, Technical University of Munich, Munich, Germany.
Fetal Diagn Ther. 2020;47(9):699-710. doi: 10.1159/000508881. Epub 2020 Jul 2.
Two-dimensional speckle tracking echocardiography (2D-STE)-based strain values of the left and the right ventricle have been established; however, less is known about atrial deformation. The aim of our study was to assess both atrial strain and ventricular strain using 2D-STE in a cardiac 4-chamber view and to investigate the effect of possible influencing factors such as gestational age.
Fetal echocardiography was performed on a Toshiba Aplio 500 ultrasound system. Based on an apical or basal 4-chamber view of the fetal heart, left and right ventricular longitudinal peak systolic strain (LVLPSS and RVLPSS) as well as left and right atrial longitudinal peak systolic strain (LALPSS and RALPSS) were assessed by 2D-STE.
A total of 101 healthy fetuses were included. The mean gestational age (GA) was 26.0 ± 5.6 weeks. GA was significantly positively correlated (p < 0.05) with LVLPSS and RVLPSS and significantly negatively correlated (p < 0.05) with LALPSS and RALPSS. The mean values for LVLPSS and RVLPSS were -17.44 ± 2.29% and -16.89 ± 1.72%. The mean values for LALPSS and RALPSS were 34.09 ± 4.17% and 35.36 ± 2.90%.
Ventricular and atrial deformation analysis in 2D-STE was technically feasible and showed comparable values to current data. For future research on myocardial function (MF) of the fetus, considering GA as an influencing factor for deformation analysis seems to be adequate. Especially, atrial deformation analysis allows the assessment of diastolic myocardial function. Further research needs to clarify the clinical meaning of these myocardial deformation indices in fetuses at risk.
已经建立了基于二维斑点追踪超声心动图（2D-STE）的左、右心室应变值；然而，关于心房变形的了解较少。本研究旨在使用 2D-STE 在心脏四腔视图中评估心房应变和心室应变，并研究可能的影响因素（如胎龄）的影响。
在东芝 Aplio 500 超声系统上进行胎儿超声心动图检查。根据胎儿心脏的 apical 或 basal 四腔视图，通过 2D-STE 评估左、右心室纵向峰值收缩应变（LVLPSS 和 RVLPSS）以及左、右心房纵向峰值收缩应变（LALPSS 和 RALPSS）。
共纳入 101 例健康胎儿。平均胎龄（GA）为 26.0 ± 5.6 周。GA 与 LVLPSS 和 RVLPSS 呈显著正相关（p < 0.05），与 LALPSS 和 RALPSS 呈显著负相关（p < 0.05）。LVLPSS 和 RVLPSS 的平均值分别为-17.44 ± 2.29%和-16.89 ± 1.72%。LALPSS 和 RALPSS 的平均值分别为 34.09 ± 4.17%和 35.36 ± 2.90%。
2D-STE 的心室和心房变形分析在技术上是可行的，并且与当前数据具有可比性。对于未来对胎儿心肌功能（MF）的研究，考虑 GA 作为变形分析的影响因素似乎是足够的。特别是，心房变形分析可以评估舒张期心肌功能。进一步的研究需要阐明这些胎儿心肌变形指标的临床意义。
