Evaluation of Right Ventricular Function and Myocardial Microstructure in Fetal Hypoplastic Left Heart Syndrome

Ma, Jun; Yuan, Yaping; Zhang, Li; Chen, Shizhen; Li, Hong; Liu, Juanjuan; Song, Xiaoyan; Shi, Jiawei; Zhang, Yi; Cui, Li; Zhou, Xin; Xie, Mingxing

doi:10.3390/jcm11154456

Cited by 6 publications

(2 citation statements)

References 37 publications

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“…Reduced global longitudinal strain (GLS) and abnormal long-axis ventricular motion were identified as primary contributors to LV subclinical dysfunction (from base to apex). While early diastolic annular motion has been linked to LV recoil, systolic annular motion has been linked to LV ejection fraction [20]. To determine whether MAC affected the LV on a regional or global scale, we compared individuals with varying degrees of MAC by analyzing the LV's six fundamental components.…”

Section: Resultsmentioning

confidence: 99%

Speckle Tracking Analysis of Mitral Annular Calcification and Left Ventricular Mechanics

Allam,

Mansy,

Fathy

2023

SEE J Cardiol

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BACKGROUND: Clinical echocardiography often reveals mitral annular calcification (MAC), and this condition has been connected to atherosclerosis and cardiovascular risk factors. To this day, our knowledge of the left ventricle’s (LV) physiology is still somewhat restricted. Using 2D speckle tracking echocardiography, we analyzed the connection between MAC and LV mechanical functions (2DSTE). AIM: The purpose of the current investigation is to assess how left ventricular mechanics are impacted by MAC. MATERIALS AND METHODS: Between April 2020 and October 2021, this prospective and cross-sectional study was carried out in Islamic Center of Cardiology Al Azhar University and Cardiology Department of Al Hussien University Hospital. Eighty participants were utilized in the study. When necessary, patients were referred to the Cardiology Clinics at the Medical Schools of Al Azhar University for follow-up care. Sixty MAC patients were studied with 20 healthy controls of similar age and gender. All patients had a 2D echocardiogram. Sixty consecutive patients with a MAC diagnosis and 20 age- and sex-matched controls with normal cardiac evaluations made up the study population. The patients were all given a 2D echocardiogram. RESULTS: The longitudinal strain significantly decreased as the MAC severity rose. The LV’s rotating mechanics varied greatly among MAC organizations. The E/A ratio, the global longitudinal speed (GLS), and the systolic tissue velocity were all shown to have a negative correlation with MAC thickness. Additional variables were found to have statistically significant connections. There were significant correlations between MAC severity and age, LV mass index, and t-LV UR. Age, LV mass index, and linear speed were significantly related to MAC severity. CONCLUSION: The LV ability to contract systolically and diastolically is compromised when MAC is both present and severe. The LV ability to contract systolically and diastolically is likewise impacted by an increase in MAC severity.

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Section: Resultsmentioning

confidence: 99%

Speckle Tracking Analysis of Mitral Annular Calcification and Left Ventricular Mechanics

Allam,

Mansy,

Fathy

2023

SEE J Cardiol

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“…Furthermore, cardiac function was related to the orientation patterns of myocardial fibers. The RV myocardium in HLH showed a more compact and organized adaptation, more resembling the global myocardial helix [ 36 ]. With RV volume loading in HLH, RV sphericity increases.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of right ventricular myocardial deformation properties in fetal hypoplastic left heart by two-dimensional speckle tracking echocardiography

Enzensberger

Graupner

Fischer

et al. 2023

Arch Gynecol Obstet

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Purpose Right ventricular (RV) function influences the outcome of hypoplastic left heart (HLH) patients. This study aimed to confirm the assumption of prenatal RV remodeling and possible influencing factors of myocardial restructuring using two-dimensional speckle tracking echocardiography (2D STE). Methods This is a retrospective cross-sectional cohort study including HLH fetuses and gestational age-matched controls. Based on a four-chamber view, cine loops were stored with 60 frames per second. Global longitudinal peak systolic strain (GLPSS) of the RV was retrospectively determined and compared to healthy controls. Furthermore, HLH subgroups were built according to the presence of left ventricular endocardial fibroelastosis (LV-EFE) and restrictive foramen ovale (FO) to investigate the effect of these compromising factors on myocardial deformation. Results A total of 41 HLH fetuses and 101 controls were included. Gestational age at fetal assessment was similarly distributed in both groups (controls: 26.0 ± 5.6 weeks vs. HLH: 29.1 ± 5.6 weeks). Relating to RV-GLPSS values, fetuses with HLH demonstrated lower mean values than healthy control fetuses (− 15.65% vs. − 16.80%, p = 0.065). Cases with LV-EFE (n = 11) showed significantly lower mean values compared to such without LV-EFE (n = 30) (RV-GLPSS: − 12.12% vs. − 16.52%, p = 0.003). No significant differences were observed for cases with FO restriction (n = 10). Conclusions In HLH the RV undergoes prenatal remodeling, leading to an adaptation of myocardial function to LV conditions. Further explorations by STE should expand knowledge about RV contraction properties in HLH and its impact on surgical outcome.

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Fetal Speckle Tracking Echocardiography Measured Global Longitudinal Strain and Strain Rate in Congenital Heart Disease: A Systematic Review and Meta‐Analysis

van den Wildenberg,

van Beynum,

Havermans

et al. 2024

Prenatal Diagnosis

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Fetal two‐dimensional speckle tracking echocardiography (2D‐STE) is a novel technique that provides information on fetal heart function by measuring global longitudinal strain (GLS) and global longitudinal strain rate (GLSR). These features assess the longitudinal deformity of the fetal cardiac wall. 2D‐STE is shown to be of prognostic value in children and adults with congenital heart disease (CHD). Therefore, its importance in fetal life should also be considered. This systematic review and meta‐analysis provides an overview of the literature on 2D‐STE (GLS/GLSR) in fetuses with CHD, focusing on the left and right ventricles (LV/RV). Findings indicated that LV‐GLS was significantly lower in fetuses with coarctation of the aorta (CoA) and Tetralogy of Fallot (ToF) compared to controls. Conversely, fetuses with a single left ventricle exhibited higher LV‐GLS. RV‐GLS was significantly lower in fetuses with hypoplastic left heart syndrome (HLHS) and ToF compared to controls. LV‐GLSR was significantly lower in fetuses with CoA. Overall, considerable heterogeneity was observed, possibly due to differences in study design. More prospective longitudinal studies on 2D‐STE in fetuses with CHD, considering heterogeneity parameters, could offer better insights into this promising technique.

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Evaluation of Right Ventricular Function and Myocardial Microstructure in Fetal Hypoplastic Left Heart Syndrome

Cited by 6 publications

References 37 publications

Speckle Tracking Analysis of Mitral Annular Calcification and Left Ventricular Mechanics

Speckle Tracking Analysis of Mitral Annular Calcification and Left Ventricular Mechanics

Evaluation of right ventricular myocardial deformation properties in fetal hypoplastic left heart by two-dimensional speckle tracking echocardiography

Fetal Speckle Tracking Echocardiography Measured Global Longitudinal Strain and Strain Rate in Congenital Heart Disease: A Systematic Review and Meta‐Analysis

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