Abnormalities of the Width of the <scp>Four‐Chamber</scp> View and the Area, Length, and Width of the Ventricles to Identify Fetuses at <scp>High‐Risk</scp> for <scp>D‐Transposition</scp> of the Great Arteries and Tetralogy of Fallot

DeVore, Greggory R.; Cuneo, Bettina F.; Sklansky, Mark; Satou, Gary

doi:10.1002/jum.16060

Cited by 5 publications

(5 citation statements)

References 26 publications

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“…It is known that in various disease states, the fetal heart not only increases the thickness of the ventricles and septum but also adapts by changing the size of the atria and ventricles [ 10 ]. The global spherical index (GSI) has been identified as an indicator of this change in cardiac shape [ 18 ]. The GSI is calculated by measuring the basal-apical length (BAL) and transverse length (TL) in a four-chamber view during the end diastole period.…”

Section: Discussionmentioning

confidence: 99%

Prenatal Diagnosis of Right-Sided Congenital Ventricular Diverticulum (CVD) Assisted by Spatiotemporal Image Correlation (STIC) Acquisition and the Speckle-Tracking Technique to Assess Fetal Cardiac Function: A Case Report

et al. 2022

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Congenital ventricular diverticulum (CVD) is a cardiac malformation defined as an outpouching lesion of a ventricle with normal contractility and thickness, and the advancement of prenatal sonography has led to its prenatal diagnosis. In the prenatal period, CVD is reported in association with pericardial effusion, arrhythmia, and fetal hydrops or as an isolated condition. With the development of prenatal echocardiography, CVD can be diagnosed from the early stage of pregnancy, and prenatal procedures, such as pericardiocentesis, are also possible. Spatiotemporal image correlation (STIC) acquisition, a novel approach for the clinical evaluation of fetal hearts, provides easy-to-use techniques for acquiring data from fetal hearts and helping visualization with two-dimensional and three-dimensional (3D) cine sequences. Furthermore, the speckle-tracking technique enables a more comprehensive evaluation of the shape, continuity, and function of the fetal heart. These recent techniques have never been used for CVD diagnosis and evaluation. Here, we present a case of right-sided CVD, which is the first in which STIC acquisition and cardiac function assessment with the speckle-tracking technique were used to assist in the diagnosis and evaluation.

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Section: Discussionmentioning

confidence: 99%

Prenatal Diagnosis of Right-Sided Congenital Ventricular Diverticulum (CVD) Assisted by Spatiotemporal Image Correlation (STIC) Acquisition and the Speckle-Tracking Technique to Assess Fetal Cardiac Function: A Case Report

et al. 2022

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“…In 2023, using a similar theme of measuring the size and shape of the ventricular chambers, our group analyzed 88 fetuses, 44 with tetralogy of Fallot and 44 with D-TGA, to determine if measurements of the 4CV and ventricles could identify fetuses at risk for either tetralogy of Fallot or D-transposition. 22 The analysis, using logistic regression analysis, identified eight end-diastolic measurements (4CV width, RV and LV area, RV and LV length, RV width at the base (Segment 1), and the RV and LV mid-chamber width (Figure 12). From these measurements, the RV base sphericity index and the RV and LV mid-chamber sphericity index were computed (Figure 12).…”

Section: Speckle Tracking Analysis Used To Simultaneously Screen Fetu...mentioning

confidence: 99%

“…22. 93.2%, with a FPR of 6.8%. 22 The benefit of this approach was that from eight simple end-diastolic measurements of the 4CV and ventricles, the probability of either tetralogy of Fallot or Dtransposition could be quickly ascertained, prompting a re-review of the outflow tract examination if either of these two malformations were not identified during the screening examination of the fetal heart. Supplement 4 is a calculator to predict the probability of either tetralogy of Fallot or D-transposition using the measurements from…”

Section: F I G U R E 1mentioning

confidence: 99%

“…From these measurements, the RV base sphericity index and the RV and LV mid‐chamber sphericity index were computed (Figure 12). 22 The sensitivity for detecting either tetralogy of Fallot or D‐transposition was 94.3% with a false‐positive rate (FPR) of 5.7%. For tetralogy of Fallot, the sensitivity was 95.5%, with an FPR of 4.5%.…”

Section: Introductionmentioning

confidence: 99%

“…For tetralogy of Fallot, the sensitivity was 95.5%, with an FPR of 4.5%. For D‐transposition, the sensitivity was 93.2%, with a FPR of 6.8% 22 . The benefit of this approach was that from eight simple end‐diastolic measurements of the 4CV and ventricles, the probability of either tetralogy of Fallot or D‐transposition could be quickly ascertained, prompting a re‐review of the outflow tract examination if either of these two malformations were not identified during the screening examination of the fetal heart.…”

Section: Introductionmentioning

confidence: 99%

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Review of speckle tracking analysis to measure the size, shape, and contractility of the fetal heart in fetuses with congenital heart defects

DeVore,

Klas,

Cuneo

et al. 2024

Echocardiography

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Evaluation of the fetal heart involves two approaches. The first describes a screening protocol in which the heart is imaged in transverse planes that includes the four‐chamber view (4CV), left and right outflow tracts, and the 3‐vessel‐tracheal view. The second approach is a fetal echocardiogram that requires additional cardiac images as well as evaluating ventricular function using diagnostic tools such as M‐mode and pulsed Doppler ultrasound. Speckle tracking analysis of the ventricular and atrial endocardium of the fetal heart has focused primarily on computing longitudinal global strain. However, the technology enabling this measurement to occur has recently been adapted to enable the clinician to obtain numerous additional measurements of the size, shape, and contractility of the ventricles and atrial chambers. By using the increased number of measurements derived from speckle tracking analysis, we have reported the ability to screen for tetralogy of Fallot, D‐transposition of the great arteries (D‐TGA), and coarctation of the aorta by only imaging the 4CV. In addition, we have found that measurements derived from speckle tracking analysis of the ventricular and atrial chambers can be used to compute the risk for emergent neonatal balloon atrial septostomy in fetuses with D‐TGA. The purpose of this review is to consolidate our experience in one source to provide perspective on the benefits of speckle tracking analysis to measure the size, shape, and contractility of the ventricles and atria imaged in the 4CV in fetuses with congenital heart defects.

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Umbilical Vein Flows and Cardiac Size, Shape, and Ventricular Contractility in Fetuses With Estimated Weight Less‐Than 10th Centile

Putra,

Peek,

Devore

et al. 2024

J of Ultrasound Medicine

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ObjectivesIn a cohort of patients with estimated fetal weights (EFWs) <10th centile, we aimed 1) to compare the prevalence of abnormalities of fetal 4‐chamber view (4CV) cardiac size, shape, and ventricular contractility in fetal growth restricted (FGR) and small‐for‐gestational‐age (SGA) fetuses and 2) to compare umbilical vein flow (UVF) measurements to standard Doppler surveillance in predicting abnormalities of cardiac function.MethodsProspective observational cohort study of fetuses with EFW <10th percentile. Measurements of size and shape used were 4CV transverse width, 4CV cardiac area, 4CV global sphericity index, and right‐to‐left ventricular mid‐chamber width ratio. Variables of contractility used were fractional shortening change at the mid‐ventricle chamber, global longitudinal strain, fractional area change, and left ventricular cardiac output. The UVF and standard Doppler surveillance including umbilical artery (UA), middle cerebral artery, and cerebroplacental ratio (CPR) were collected. Control data were from previously published studies.ResultsA total of 95 fetuses with EFWs <10th centile were included in the study. The rates of abnormalities of cardiac size and shape and ventricular contractility were all significantly elevated compared with normally grown control fetuses but similar between FGR and SGA fetuses. In a subset of 76 patients with UVF data, evaluation UVF identified more patients with any abnormality of contractility compared with UA (37.9 vs 17.2%, P = .02).ConclusionsThe addition of UVF doubled the detection rate of ventricular contractility abnormalities. The addition of UVF should be considered in the surveillance of FGR and SGA fetuses to further stratify the severity of hypoxemia and to identify those at greater risk for future cardiovascular dysfunction.

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Abnormalities of the Width of the Four‐Chamber View and the Area, Length, and Width of the Ventricles to Identify Fetuses at High‐Risk for D‐Transposition of the Great Arteries and Tetralogy of Fallot

Cited by 5 publications

References 26 publications

Prenatal Diagnosis of Right-Sided Congenital Ventricular Diverticulum (CVD) Assisted by Spatiotemporal Image Correlation (STIC) Acquisition and the Speckle-Tracking Technique to Assess Fetal Cardiac Function: A Case Report

Prenatal Diagnosis of Right-Sided Congenital Ventricular Diverticulum (CVD) Assisted by Spatiotemporal Image Correlation (STIC) Acquisition and the Speckle-Tracking Technique to Assess Fetal Cardiac Function: A Case Report

Review of speckle tracking analysis to measure the size, shape, and contractility of the fetal heart in fetuses with congenital heart defects

Umbilical Vein Flows and Cardiac Size, Shape, and Ventricular Contractility in Fetuses With Estimated Weight Less‐Than 10th Centile

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