Echocardiographic Researches
Asssessment of fetal cardiac geometry and systolic function in fetuses with ventricular septal defect during second trimester using fetal heart quantification technology
Hou Li, Yin Lixue, Zhang Dongmei, Zhou Liuying, Li Chunrong, Peng Shiyue
Published 2024-06-25
Cite as Chin J Ultrasonogr, 2024, 33(6): 497-504. DOI: 10.3760/cma.j.cn131148-20240308-00142
Abstract
ObjectiveTo evaluate the morphological and functional changes of the heart during second trimester fetuses with ventricular septal defect (VSD) using fetal heart quantification (fetal HQ) technology.
MethodsA prospective study was conducted from July 2022 to January 2024 at Chengdu Women′s and Children′s Central Hospital, collecting 91 singleton fetuses diagnosed with isolated VSD (VSD group) and 91 normal fetuses matched for gestational age (control group). Fetal HQ technology was used to measure the length and width of the four-chamber view of the fetal heart, obtaining the global sphericity index (GSI). Speckle tracking technology was used to track the endocardial motion trajectories of the left and right ventricles during diastole and systole, obtaining parameters such as left and right ventricular global longitudinal strain (LV-GLS and RV-GLS), end-diastolic diameter (EDD), 24-segment sphericity index (SI), 24-segment fraction of shortening (FS), left ventricular ejection fraction (LV-EF), fraction of area change (FAC), left ventricular stroke volume (LV-SV), and left ventricular cardiac output (LV-CO).The differences between groups were compared, and the correlations between the values of VSD and GSI, GLS, and FAC were evaluated.
ResultsThe EDD of the left ventricular segments 20-23 in the VSD group was lower, while the SI value of the right ventricular segments 1-4 in the VSD group was higher than that in the control group (all P<0.05). There was no statistically significant difference in GSI between the two groups (P>0.05). LV-GLS in the VSD group was lower than that in the control group (P<0.05). There was no statistically significant difference in RV-GLS (P>0.05). Values of LV-FAC, LV-EF, LV-SV, and LV-CO in the VSD group were significantly lower than those in the control group (all P<0.05). The FS value of left ventricular segments 1-10 in the VSD group presented lower, but the FS value of right ventricular segments 7-21 higher compared to controls(all P<0.05). LV-GLS and LV-FAC absolute values were negatively correlated with the size of VSD (r=-0.309, P=0.004; r=-0.264, P=0.015), while GSI, RV-GLS, and RV-FAC showed no significant correlation with the size of VSD (all P>0.05).
ConclusionsThe overall sphericity index of second trimester VSD fetuses is normal, but there are changes in the shape of the left ventricular apical segments and the right ventricular basal segments, with the left heart chamber tending to be flatter and the right heart chamber more fusiform. The left ventricular systolic function of VSD fetuses is significantly reduced, the local systolic function of right ventricular increases while the global systolic function shows no significant change. The absolute values of LV-GLS and LV-FAC in VSD fetuses are negatively correlated with the size of VSD.
Key words:
Ultrasonography; Fetus; Ventricular septal defect; Quantification technology; Heart; Ventricular function
Contributor Information
Hou Li
Clinical Medicine Academy, Southwest Medical University, Luzhou 646000, China
Department of Ultrasound, Chengdu Women′s and Children′s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 611731, China
Yin Lixue
Clinical Medicine Academy, Southwest Medical University, Luzhou 646000, China
Institute of Ultrasound in Medicine, Sichuan Provincial People′s Hospital, the Affiliated Hospital of University of Electronics Science and Technology, Key Laboratory of Ultrasound in Cardiac Electrophysiology and Biomechanics of Sichuan Province, Chengdu 610072, China
Zhang Dongmei
Department of Ultrasound, Chengdu Women′s and Children′s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 611731, China
Zhou Liuying
Department of Ultrasound, Chengdu Women′s and Children′s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 611731, China
Li Chunrong
Department of Ultrasound, Chengdu Women′s and Children′s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 611731, China
Peng Shiyue
City University of Hong Kong, Hongkong 999077, China
