Analysis of Segmental and Global Function of the Fetal Heart Using Novel Automatic Functional Imaging

Ta‐Shma, Asaf; Perles, Zeev; Gavri, Sagui; Golender, Julius; Tarshansky, Shulamit; Shlichter, Chava; Tov, Hadassah Bar; Rein, Azaria J.J.T.

doi:10.1016/j.echo.2007.05.007

Cited by 73 publications

(91 citation statements)

References 17 publications

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“…Technique variation and variation in reporting (global versus regional values) may also be factors contributing to discrepant results across studies. 310,311,313,317 The clinical relevance of the information obtained with strain techniques with respect to fetal myocardial function remains to be proven. Concerns exist about vendor-specific image acquisition, storage, and processing, resulting in limited cross-vendor applicability.…”

Section: Strain and Strain Rate Imagingmentioning

confidence: 99%

“…233,[308][309][310][311][312][313][314][315][316][317][318][319] Several of these studies have applied 2D speckle tracking echocardiography to the normal midgestation to late-gestation fetus for the assessment of longitudinal mechanics, although only 1 study to date has also addressed circumferential strain. 318 In general, feasibility is reasonable, although some studies have reported up to 20% to 30% interobserver variability.…”

Section: Strain and Strain Rate Imagingmentioning

confidence: 99%

See 1 more Smart Citation

Diagnosis and Treatment of Fetal Cardiac Disease

Donofrio¹,

Moon-Grady²,

Hornberger³

et al. 2014

Circulation

1,016

543

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Background— The goal of this statement is to review available literature and to put forth a scientific statement on the current practice of fetal cardiac medicine, including the diagnosis and management of fetal cardiovascular disease. Methods and Results— A writing group appointed by the American Heart Association reviewed the available literature pertaining to topics relevant to fetal cardiac medicine, including the diagnosis of congenital heart disease and arrhythmias, assessment of cardiac function and the cardiovascular system, and available treatment options. The American College of Cardiology/American Heart Association classification of recommendations and level of evidence for practice guidelines were applied to the current practice of fetal cardiac medicine. Recommendations relating to the specifics of fetal diagnosis, including the timing of referral for study, indications for referral, and experience suggested for performance and interpretation of studies, are presented. The components of a fetal echocardiogram are described in detail, including descriptions of the assessment of cardiac anatomy, cardiac function, and rhythm. Complementary modalities for fetal cardiac assessment are reviewed, including the use of advanced ultrasound techniques, fetal magnetic resonance imaging, and fetal magnetocardiography and electrocardiography for rhythm assessment. Models for parental counseling and a discussion of parental stress and depression assessments are reviewed. Available fetal therapies, including medical management for arrhythmias or heart failure and closed or open intervention for diseases affecting the cardiovascular system such as twin–twin transfusion syndrome, lung masses, and vascular tumors, are highlighted. Catheter-based intervention strategies to prevent the progression of disease in utero are also discussed. Recommendations for delivery planning strategies for fetuses with congenital heart disease including models based on classification of disease severity and delivery room treatment will be highlighted. Outcome assessment is reviewed to show the benefit of prenatal diagnosis and management as they affect outcome for babies with congenital heart disease. Conclusions— Fetal cardiac medicine has evolved considerably over the past 2 decades, predominantly in response to advances in imaging technology and innovations in therapies. The diagnosis of cardiac disease in the fetus is mostly made with ultrasound; however, new technologies, including 3- and 4-dimensional echocardiography, magnetic resonance imaging, and fetal electrocardiography and magnetocardiography, are available. Medical and interventional treatments for select diseases and strategies for delivery room care enable stabilization of high-risk fetuses and contribute to improved outcomes. This statement highlights what is currently known and recommended on the basis of evidence and experience in the rapidly advancing and highly specialized field of fetal cardiac care.

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Section: Strain and Strain Rate Imagingmentioning

confidence: 99%

Section: Strain and Strain Rate Imagingmentioning

confidence: 99%

Diagnosis and Treatment of Fetal Cardiac Disease

Donofrio¹,

Moon-Grady²,

Hornberger³

et al. 2014

Circulation

1,016

543

View full text Add to dashboard Cite

show abstract

“…24 At the present time, fetal studies using 2D CPA have focused on the 4-chamber view, analyzing either the left or right ventricular chambers. [26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43] Therefore, the nomenclature for segmental analysis has to be reconsidered to include the ventricular basal lateral wall and septum, the mid lateral wall and septum, and the apical lateral wall and septum for both right and left ventricles (Figure 8). When the heart is oriented with the apex in the oblique or perpendicular positions, the full thickness of the walls and septum may be imaged and the endocardium clearly delineated.…”

Section: Increasing the Size Of The Imagementioning

confidence: 99%

“…25 Two-dimensional speckle-tracking analysis of the fetal heart has been of interest to investigators since 2005. [26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43] Although there have been differences in equipment and findings, this technology has the potential for broad application in fetal medicine. Deformation analysis has been evaluated in fetuses with twin-twin transfusion syndrome, intrauterine growth restriction, maternal diabetes, as well as other fetal conditions.…”

mentioning

confidence: 99%

Two‐Dimensional Speckle Tracking of the Fetal Heart

DeVore

Polanco²,

Satou

et al. 2016

J of Ultrasound Medicine

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Various approaches to 2‐dimensional speckle tracking have been used to evaluate left ventricular function and deformation in the fetus, child, and adult. In 2015, because of differences in imaging devices and analytical programs, the cardiology community published a consensus document proposing standards for pediatric/adult deformation imaging using 2‐dimensional speckle tracking. The understanding and application of deformation imaging in the fetus have been limited by a lack of uniform software, terminology, techniques, and display. This article provides a practical, step‐by‐step approach for deformation analysis of the fetal heart using offline software that is independent of specific ultrasound vendors.

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“…Other color tissue Doppler studies reported about increasing annular velocities during gestation in normal fetuses placing the ROI in the RV free wall or annulus 14,15 . We think, that measurements of tissue velocities are highly dependent on region of interest placement (even close to the atrioventricular level), the basically undefined ROI size (in the literature this ranges between 1 and 3mm) and the different ultrasound machines with post-processing algorithms [14][15][16][17][18][19][20] . Therefore, published tissue velocities vary and cannot be used interchangeably.…”

confidence: 99%

Segmental Myocardial Displacement and Tissue Velocity Analysis of the Right Ventricle in Hypoplastic Left Heart Syndrome Fetuses and Controls Using Color Tissue Doppler Imaging (C-TDI)

Graupner

Enzensberger

Wieg

et al. 2017

Prenatal Cardiology

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Introduction: The long-term outcome of patients with HLHS (hypoplastic left heart syndrome) is mainly determined by right ventricular function. Our study examines, whether there are differences in segmental right ventricular myocardial displacement and tissue velocities of fetuses with HLHS compared to healthy fetuses during gestation.Materials and methods: A prospective study was conducted including 20 fetuses with HLHS and 20 gestational age matched controls. c-TDI (colour tissue Doppler imaging) derived systolic and diastolic velocities as well as myocardial displacement were assessed in three different locations of the right ventricle (RV). A ROI (region of interest) was placed in the basal, middle and apical part of the myocardium. Possible changes of c-TDI indices in the course of pregnancy and between the three different segments were investigated in both groups.Results: HLHS fetuses showed significantly lower e' velocities measured in the basal and middle part of the RV compared to healthy controls (p < 0.05). Basal displacement showed significantly lower values in HLHS fetuses compared to controls. In control fetuses but not in HLHS fetuses there was a significant increase of basal diastolic velocities and displacement in the course of pregnancy. According to myocardial velocities and displacement values there was a significant decrease from the base of the fetal heart to the apex pointed in both groups.Conclusions: An altered right ventricular myocardial function in HLHS fetuses within different myocardial segments could be demonstrated. An apicobasal gradient with higher velocity and displacement values in the basal part of RV myocardium could be found in both groups. The technique may be of value in the prenatal assessment of myocardial function, however its role as a monitoring tool and outcome predictor needs to be defined.

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Analysis of Segmental and Global Function of the Fetal Heart Using Novel Automatic Functional Imaging

Cited by 73 publications

References 17 publications

Diagnosis and Treatment of Fetal Cardiac Disease

Diagnosis and Treatment of Fetal Cardiac Disease

Two‐Dimensional Speckle Tracking of the Fetal Heart

Segmental Myocardial Displacement and Tissue Velocity Analysis of the Right Ventricle in Hypoplastic Left Heart Syndrome Fetuses and Controls Using Color Tissue Doppler Imaging (C-TDI)

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