Hu Wenjing, Wang Mingyue, Bian Jinyan, Ding Jin, Liu Wen, Gu Xinxian
Department of Ultrasound, The Fourth Affiliated Hospital of Soochow University, Suzhou, China.
Department of Gynecology and Obstetrics, The First Affiliated Hospital of Soochow University, Suzhou, China.
Transl Pediatr. 2024 Jul 31;13(7):1106-1118. doi: 10.21037/tp-24-123. Epub 2024 Jul 29.
The study of fetal heart is receiving increasing attention. Fetal heart quantification (Fetal HQ) technology is a new speckle tracking technology that can analyze the 24-segment morphology and function of fetal ventricles. This study aims to use Fetal HQ to assess the changes in the structure and function of the fetal heart in normal mid to late pregnancy, providing a foundation for the clinical application of fetal cardiac speckle tracking technology.
The heart size, global sphericity index (GSI), left ventricular [stroke volume (SV)], cardiac output (CO), ejection fraction (EF), global longitudinal strain (GLS), fractional area change (FAC), 24-segment end-diastolic diameter (EDD), sphericity index (SI) and fractional shortening (FS) of the two ventricles of 500 normal pregnant fetuses were evaluated by Fetal HQ. The subjects were divided into 5 groups according to gestational weeks (GA), and the changes of fetal heart morphology and function were observed. P<0.05 indicated the statistically significant difference.
The fetal heart rate decreased gradually with the increase of GA (P<0.05). The size parameters of the fetal heart and two ventricles gradually increased with increasing GA (P<0.05). The 24 segments EDD of both ventricles increased with increasing GA (P<0.05), while the EDD increased first and then decreased from the ventricle base to the apex. The GSI and the 24 segments SI of two ventricles were basically not significantly different among the groups (P>0.05). The EF, GLS, FAC of the left ventricle and the GLS, FAC of the right ventricle decreased with the increase of GA (P<0.05), and SV and CO increased with increasing GA (P<0.05). The 24 segments FS of the left ventricle showed a downward trend with the increase of GA and gradually increased from the base to the apex. The FS of most segments of the right ventricle decreased with the increase of the GA and increased first and then decreased from the base to the apex.
The whole and segmental size parameters of fetal heart can quantitatively evaluate the growth and development of fetal heart; the GSI and segmental SI are reliable morphological indexes for evaluating fetal heart; fetal ventricular function parameters EF, FAC, GLS and segmental FS can evaluate fetal cardiac function. The Fetal HQ technique can help us to evaluate the heart growth and development of normal fetuses in the second and third trimester of pregnancy.
胎儿心脏的研究日益受到关注。胎儿心脏量化（Fetal HQ）技术是一种新的斑点追踪技术，可分析胎儿心室的24节段形态和功能。本研究旨在使用Fetal HQ评估正常妊娠中晚期胎儿心脏结构和功能的变化，为胎儿心脏斑点追踪技术的临床应用提供依据。
采用Fetal HQ评估500例正常妊娠胎儿的心脏大小、整体球形指数（GSI）、左心室[每搏输出量（SV）]、心输出量（CO）、射血分数（EF）、整体纵向应变（GLS）、面积变化分数（FAC）、两个心室的24节段舒张末期直径（EDD）、球形指数（SI）和缩短分数（FS）。根据孕周（GA）将研究对象分为5组，观察胎儿心脏形态和功能的变化。P<0.05表示差异有统计学意义。
胎儿心率随GA增加逐渐下降（P<0.05）。胎儿心脏及两个心室的大小参数随GA增加逐渐增大（P<0.05）。两个心室的24节段EDD随GA增加而增大（P<0.05），而从心室基部到心尖EDD先增大后减小。两组间两个心室的GSI和24节段SI基本无显著差异（P>0.05）。左心室的EF、GLS、FAC以及右心室的GLS、FAC随GA增加而降低（P<0.05），SV和CO随GA增加而升高（P<0.05）。左心室的24节段FS随GA增加呈下降趋势，从基部到心尖逐渐增大。右心室大部分节段的FS随GA增加而降低，从基部到心尖先增大后减小。
胎儿心脏的整体和节段大小参数可定量评估胎儿心脏的生长发育；GSI和节段SI是评估胎儿心脏的可靠形态学指标；胎儿心室功能参数EF、FAC、GLS和节段FS可评估胎儿心功能。Fetal HQ技术有助于我们评估妊娠中晚期正常胎儿的心脏生长发育情况。
