Hou Min, Xie Dan, Wan Jie, Li Pin, Zhou Xuan
Department of Ultrasonography, Heyou Hospital, Shunde District, Foshan City, 528306, China.
Department of Gynecology, Affiliated Hospital of Hebei University, Baoding, 071000, China.
BMC Pregnancy Childbirth. 2025 Aug 8;25(1):828. doi: 10.1186/s12884-025-07936-y.
Intrauterine exposure to anti SSA/Ro and anti SSB/La antibodies has been associated with the development of fetal congenital heart block and, in severe cases, fetal demise. Therefore, early and accurate assessment of fetal cardiac function is of critical importance. Velocity vector imaging (VVI) is an emerging technique capable of providing a detailed assessment of cardiac function. This study aimed to assess and compare left ventricular myocardial function in fetuses of pregnant women with and without anti-Ro/SSA or anti-La/SSB antibodies, and to explore the correlation between global myocardial function parameters and gestational age using VVI technology.
A total of 90 pregnant women with anti-Ro/SSA or anti-La/SSB antibodies were enrolled as the study group, and 90 pregnant women without autoimmune antibodies were included as the control group. Participants were stratified into four subgroups based on their gestational age. Fetal left ventricular regional and global velocities, strain, strain rate, and additional myocardial parameters were measured using ultrasound-based VVI.
Several regional longitudinal myocardial parameters of the fetal left ventricle were significantly lower in the study group compared to the control group ( < 0.05). Similarly, global longitudinal myocardial parameters were significantly reduced in the study group than those in the control group ( < 0.05). In both groups, the global peak velocity of fetal left ventricle increased with advancing gestational age. However, no statistically significant difference was observed between gestational age and either strain or peak strain rate ( > 0.05).
VVI-derived parameters effectively reflect early alterations in myocardial mechanics in fetuses exposed to anti-Ro/SSA or anti-La/SSB antibodies. This modality enables quantitative evaluation of both regional and global myocardial motion and may assist clinicians in timely identification of myocardial dysfunction. Moreover, global VVI parameters hold potential as early indicators of myocardial impairment in this high-risk population.
胎儿在子宫内暴露于抗SSA/Ro和抗SSB/La抗体与胎儿先天性心脏传导阻滞的发生有关，在严重情况下可导致胎儿死亡。因此，早期准确评估胎儿心脏功能至关重要。速度向量成像（VVI）是一种能够详细评估心脏功能的新兴技术。本研究旨在评估和比较有和没有抗Ro/SSA或抗La/SSB抗体的孕妇胎儿的左心室心肌功能，并使用VVI技术探讨整体心肌功能参数与胎龄之间的相关性。
共纳入90例有抗Ro/SSA或抗La/SSB抗体的孕妇作为研究组，90例无自身免疫抗体的孕妇作为对照组。根据胎龄将参与者分为四个亚组。使用基于超声的VVI测量胎儿左心室局部和整体速度、应变、应变率及其他心肌参数。
与对照组相比，研究组胎儿左心室的几个局部纵向心肌参数显著降低（<0.05）。同样，研究组的整体纵向心肌参数也比对照组显著降低（<0.05）。在两组中，胎儿左心室的整体峰值速度均随胎龄增加而增加。然而，胎龄与应变或峰值应变率之间未观察到统计学上的显著差异（>0.05）。
VVI得出的参数有效地反映了暴露于抗Ro/SSA或抗La/SSB抗体的胎儿心肌力学的早期改变。这种方法能够对局部和整体心肌运动进行定量评估，并可能帮助临床医生及时识别心肌功能障碍。此外，整体VVI参数有望作为这一高危人群心肌损伤的早期指标。
