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孕中期使用胎儿心脏定量技术评估室间隔缺损胎儿的心脏几何形态和收缩功能

Assessment of Fetal Cardiac Geometry and Systolic Function in Fetuses With Ventricular Septal Defect During the Second Trimester Using Fetal Heart Quantification Technology.

作者信息

Hou Li, Zhang Dongmei, Li Chunrong, Zhou Liuying, Peng Shiyue, Yin Lixue, Luo Tongyong

机构信息

School of Medicine, Chengdu Women's and Children's Central Hospital, University of Electronic Science and Technology of China, Chengdu, China.

City University of Hong Kong, Hong Kong, China.

出版信息

Prenat Diagn. 2025 May;45(5):638-648. doi: 10.1002/pd.6783. Epub 2025 Apr 1.

DOI:10.1002/pd.6783
PMID:40169401
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12054389/
Abstract

OBJECTIVE

This study aimed to assess the impact of ventricular septal defect (VSD) on fetal cardiac geometry and systolic function during the second trimester using Fetal Heart Quantification (Fetal HQ) technology.

METHODS

In this prospective study, 91 fetuses with isolated VSD and 91 gestational age-matched healthy controls were evaluated. Using the GE Voluson E10 ultrasound system and Fetal HQ software, cardiac parameters such as global sphericity index (GSI), global longitudinal strain (GLS), ejection fraction (EF), and fractional area change (FAC) were measured. Segmental end-diastolic diameters (EDD) and sphericity indices (SI) for both ventricles were analyzed. Statistical analyses compared groups and assessed correlations between VSD size and left ventricular function.

RESULTS

The VSD group displayed significant reductions in left ventricular segmental EDD and increases in right ventricular SI, reflecting localized geometric changes. Left ventricular GLS, EF, FAC, and stroke volume were notably reduced in the VSD group, indicating compromised function. VSD size negatively correlated with left ventricular GLS and FAC.

CONCLUSION

VSD significantly affects left ventricular geometry and function, with larger defects showing greater impairment. Fetal HQ technology effectively characterizes these changes, aiding early diagnosis and enabling personalized perinatal management.

摘要

目的

本研究旨在使用胎儿心脏量化(Fetal HQ)技术评估孕中期室间隔缺损(VSD)对胎儿心脏几何形状和收缩功能的影响。

方法

在这项前瞻性研究中,对91例孤立性室间隔缺损胎儿和91例孕周匹配的健康对照进行了评估。使用GE Voluson E10超声系统和Fetal HQ软件,测量了心脏参数,如整体球形指数(GSI)、整体纵向应变(GLS)、射血分数(EF)和面积变化分数(FAC)。分析了两个心室的节段性舒张末期直径(EDD)和球形指数(SI)。统计分析比较了各组,并评估了室间隔缺损大小与左心室功能之间的相关性。

结果

室间隔缺损组左心室节段性EDD显著减小,右心室SI增加,反映了局部几何形状的变化。室间隔缺损组左心室GLS、EF、FAC和每搏输出量显著降低,表明功能受损。室间隔缺损大小与左心室GLS和FAC呈负相关。

结论

室间隔缺损显著影响左心室几何形状和功能,缺损越大,损害越严重。胎儿心脏量化技术有效地表征了这些变化,有助于早期诊断并实现个性化围产期管理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/08d1/12054389/20e316d5d965/PD-45-638-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/08d1/12054389/9a1557fa5d15/PD-45-638-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/08d1/12054389/20e316d5d965/PD-45-638-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/08d1/12054389/9a1557fa5d15/PD-45-638-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/08d1/12054389/20e316d5d965/PD-45-638-g002.jpg

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本文引用的文献

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Early Clinical Outcomes in Infants with Prenatally Diagnosed Perimembranous and Muscular Ventricular Septal Defects (VSDs).产前诊断的膜周部和肌部室间隔缺损(VSD)婴儿的早期临床结局。
Pediatr Cardiol. 2024 Mar;45(3):491-499. doi: 10.1007/s00246-023-03390-9. Epub 2024 Jan 20.
2
Risk factor analysis for adverse prognosis of the fetal ventricular septal defect (VSD).胎儿室间隔缺损(VSD)不良预后的危险因素分析。
BMC Pregnancy Childbirth. 2023 Sep 21;23(1):683. doi: 10.1186/s12884-023-05969-9.
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The current state and potential innovation of fetal cardiac MRI.
胎儿心脏磁共振成像的现状与潜在创新
Front Pediatr. 2023 Jul 14;11:1219091. doi: 10.3389/fped.2023.1219091. eCollection 2023.
4
Characteristics and outcomes of fetal ventricular aneurysm and diverticulum: combining the use of a new technique, fetal HQ.胎儿心室动脉瘤和憩室的特征与结局:结合使用新技术——胎儿HQ
Front Pediatr. 2023 May 4;11:1165972. doi: 10.3389/fped.2023.1165972. eCollection 2023.
5
Evaluation of changes of cardiac morphology and function in fetuses with ductus arteriosus constriction by Speckle-tracking echocardiography.应用斑点追踪超声心动图评估动脉导管狭窄胎儿心脏形态和功能的变化
Front Pediatr. 2023 Feb 2;11:1085352. doi: 10.3389/fped.2023.1085352. eCollection 2023.
6
Evaluation of Fetal Cardiac Geometry and Contractility in Gestational Diabetes Mellitus by Two-Dimensional Speckle-Tracking Technology.二维斑点追踪技术评估妊娠期糖尿病胎儿心脏几何形态和收缩功能
Diagnostics (Basel). 2022 Aug 24;12(9):2053. doi: 10.3390/diagnostics12092053.
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Speckle-Tracking Analysis in Fetuses With Tetralogy of Fallot: Evaluation of Right and Left Ventricular Contractility and Left Ventricular Function.法洛四联症胎儿的斑点追踪分析:左右心室收缩性及左心室功能评估
J Ultrasound Med. 2022 Dec;41(12):2955-2964. doi: 10.1002/jum.15987. Epub 2022 Apr 9.
8
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Fetal cardiac geometry and function in pregnancies with well-controlled gestational diabetes mellitus using Fetal HQ.应用胎儿 HQ 技术评估血糖控制良好的妊娠期糖尿病胎儿心脏的几何结构和功能。
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