Left Ventricular Rotational and Twist Mechanics in the Human Fetal Heart

Li, Ling; Craft, Mary; Hsu, Heng-Shou; Zhang, Ming; Klas, Berthold; Danford, David A.; Kutty, Shelby

doi:10.1016/j.echo.2017.04.006

Cited by 22 publications

(30 citation statements)

References 26 publications

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“…Racial differences in fetal LV twist: This is the first study examining the feasibility and reproducibility of LV twist measurements with 2DSTE in an Asian population, while one similar study was conducted in a Western population. 15) As described in the discussion, there are racial differences in LV function and echocardiographic windows, [16][17][18][19] and this is one of advantages of our study. On the other hand, it also should be recognized there might be racial differences in the interpretation of our results.…”

Section: Discussionmentioning

confidence: 93%

“…2DSTE is expected to overcome the limitations of 2D fetal echocardiography, and some previous studies reported the feasibility of 2DSTE in the fetus. [11][12][13][14][15] Enzensberger, et al reported that they were able to analyze right and LV longitudinal strain in 88% of fetuses at gestational ages between 19 and 37 weeks. 14) Ishii, et al reported that they were able to analyze circumferential strain in 69% of fetuses at gestational ages between 17 and 42 weeks, and their intra-and interobserver correlation coefficients were 0.78 and 0.64, respectively.…”

Section: Discussionmentioning

confidence: 99%

“…We might think that LV twist analysis are feasible for clinical practice in a substantial population, although there is still room for improvement. [11][12][13][14][15] LV twist in fetuses: One of the advantages of LV twist is that it may provide both systolic and diastolic function 6,7) in cases where the LV short-axis view can be obtained at two levels. LV twisting and untwisting motions are gener- ated as a result of the dynamic interaction between obliquely oriented epicardial and endocardial fibers wound in opposite directions.…”

Section: Discussionmentioning

confidence: 99%

“…[8][9][10] Recently, several studies have reported on 2DSTE's feasibility for assessing cardiac function in the fetus, but the results were inconsistent. [11][12][13][14][15] Li, et al 15) reported the feasibility of measuring fetal LV twist by 2DSTE, and this study was performed in a Western population. However, physical and racial differences can influence cardiac function and echocardiographic windows.…”

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confidence: 99%

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Feasibility and Reproducibility of Fetal Left Ventricular Twist Using Two-Dimensional Speckle-Tracking Analysis in a Japanese Population

et al. 2019

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In fetal echocardiography, conventional parameters for assessing cardiac function are limited because of limited echocardiographic windows or the fetus' position. We aimed to evaluate the feasibility and reproducibility of fetal left ventricular (LV) twist by two-dimensional, speckle-tracking echocardiography (2DSTE) in a Japanese population.We included 55 normal fetuses at gestational ages between 21 and 36 weeks. Subjects with adverse maternal health issues were excluded. LV twist was calculated as the net difference between LV basal and apical rotation at end-systole estimated with 2DSTE.We were able to analyze the 2DSTE images in 44 cases (80%). The mean (±SE) apical rotation, basal rotation, and LV twist were 7.88 ± 0.77, −3.68 ± 0.50, and 11.1 ± 0.75 degrees, respectively. We could not analyze 11 cases (20%) because of poor image quality due to fetal position in five cases (45.5%), failure to track the endocardium because of blurred images in five cases (45.5%), and failure to obtain images of the heart due to the presence of the placenta in front of the fetus in one case (9.1%). There were no significant differences in the demographic data between pregnant women in whom LV twist analysis was feasible and not feasible. The intra-and interobserver intraclass correlation coefficients were 0.67 and 0.64, respectively.LV twist analysis by 2DSTE in the fetus was feasible in a substantial population and may provide new insight into cardiac function during the prenatal period. On the other hand, its reproducibility was moderate and needs to be improved.(Int Heart J 2019; 60: 671-678)

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Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Feasibility and Reproducibility of Fetal Left Ventricular Twist Using Two-Dimensional Speckle-Tracking Analysis in a Japanese Population

et al. 2019

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“…The application of speckle tracking imaging (STI) has permitted reliable assessment of LV torsional mechanics with reported good reproducibility in the adult population. However, data on assessment of LV rotational mechanics in the fetus and neonate are very limited. LV torsional mechanics of fetal perinatal adaptation have not been explored previously.…”

Section: Introductionmentioning

confidence: 99%

Left ventricular torsional mechanics in term fetuses and neonates

Patey

Carvalho

Thilaganathan

2020

Ultrasound in Obstet & Gyne

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Objective Left ventricular (LV) torsion is an important aspect of cardiac mechanics and is fundamental to normal ventricular function. The myocardial mechanics of the fetal heart and the changes that occur during the transition to the neonatal period have not been explored previously. The aim of this study was to evaluate perinatal changes in LV torsion and its relationship with myocardial function. Methods This was a prospective study of 36 women with an uncomplicated term pregnancy. Fetal and neonatal conventional, spectral tissue Doppler and two‐dimensional (2D) speckle tracking echocardiography were performed a few days before and within hours after delivery to measure cardiac indices including LV rotational parameters derived from short‐axis views at the base and apex of the heart. Linear regression analysis was used to examine the relationship between LV rotational parameters and cardiac geometric and functional indices in term fetuses and neonates. Perinatal changes in LV rotational parameters were assessed. Results There were three patterns of LV twist in term fetuses: those with reversed‐apex‐type LV twist had the lowest median values of LV torsion (0.1°/cm), with higher values (1.6°/cm) in those with infant‐type LV twist and the highest values (4.4°/cm) in those with adult‐type LV twist. LV torsion was associated significantly with cardiac geometric and functional indices. Perinatal evaluation revealed a significant increase in LV torsion following delivery in fetuses exhibiting reversed‐apex‐type LV twist (increase of 2.8°/cm, P = 0.009) and a significant decrease in those with adult‐type LV twist (decrease of 3.2°/cm, P = 0.008). Conclusions This study demonstrates the feasibility of 2D speckle tracking imaging for accurate assessment of rotational cardiac parameters in term fetuses. There are unique perinatal patterns of LV twist that demonstrate different values of LV torsion, which was found to correlate with indices of ventricular geometry and myocardial function. Differences in patterns of LV twist may therefore reflect differences in compensatory myocardial adaptation to the physiological environment/loading conditions in late gestation in fetuses and postnatal cardiac adjustment to the acute loading changes that occur at delivery. Copyright © 2019 ISUOG. Published by John Wiley & Sons Ltd.

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Diastolic Ventricular Function Assessment

Frommelt

2021

Echocardiography in Pediatric and Congenital Heart Disease

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Left Ventricular Rotational and Twist Mechanics in the Human Fetal Heart

Cited by 22 publications

References 26 publications

Feasibility and Reproducibility of Fetal Left Ventricular Twist Using Two-Dimensional Speckle-Tracking Analysis in a Japanese Population

Feasibility and Reproducibility of Fetal Left Ventricular Twist Using Two-Dimensional Speckle-Tracking Analysis in a Japanese Population

Left ventricular torsional mechanics in term fetuses and neonates

Diastolic Ventricular Function Assessment

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