Assessing Fetal Cardiac Function by Measuring Myocardial Radial Velocity Using the Phased-Tracking Method

Ozawa, Keiya; Murotsuki, Jun; Miyashita, Shuhei; Muromoto, Jin; Hasegawa, Hideyuki; Kanai, Hiroshi; Yaegashi, Nobuo

doi:10.1159/000371514

Cited by 8 publications

(9 citation statements)

References 25 publications

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“… 11 , 24 , 51 , 58 This could be explained by the varying severity of IUGR cases studied. Ozawa et al 59 reported nonsignificant decreases of LVFS and RVFS in IUGR human fetuses and explained that this was a result of the inclusion of many mild IUGR cases. Our rat IUGR model can thus be a model for the more severe cohort in this aspect.…”

Section: Discussionmentioning

confidence: 99%

Echocardiographic assessment of fetal cardiac function in the uterine artery ligation rat model of IUGR

et al. 2021

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Background Intrauterine growth restriction (IUGR) leads to cardiac dysfunction and adverse remodeling of the fetal heart, as well as a higher risk of postnatal cardiovascular diseases. The rat model of IUGR, via uterine artery ligation, is a popular model but its cardiac sequelae is not well investigated. Here, we performed an echocardiographic evaluation of its cardiac function to determine how well it can represent the disease in humans. Methods Unilateral uterine artery ligation was performed at embryonic day 17 (E17) and echocardiography was performed at E19 and E20. Results Growth-restricted fetuses were significantly smaller and lighter, and had an higher placenta-to-fetus weight ratio. Growth-restricted fetal hearts had reduced wall thickness-to-diameter ratio, indicating left ventricular (LV) dilatation, and they had elevated trans-mitral and trans-tricuspid E/A ratios and reduced left and right ventricular fractional shortening (FS), suggesting systolic and diastolic dysfunction. These were similar to human IUGR fetuses. However, growth-restricted rat fetuses did not demonstrate head-sparing effect, displayed a lower LV myocardial performance index, and ventricular outflow velocities were not significantly reduced, which were dissimilar to human IUGR fetuses. Conclusions Despite the differences, our results suggest that this IUGR model has significant cardiac dysfunction, and could be a suitable model for studying IUGR cardiovascular physiology. Impact Animal models of IUGR are useful, but their fetal cardiac function is not well studied, and it is unclear if they can represent human IUGR fetuses. We performed an echocardiographic assessment of the heart function of a fetal rat model of IUGR, created via maternal uterine artery ligation. Similar to humans, the model displayed LV dilatation, elevated E/A ratios, and reduced FS. Different from humans, the model displayed reduced MPI, and no significant outflow velocity reduction. Despite differences with humans, this rat model still displayed cardiac dysfunction and is suitable for studying IUGR cardiovascular physiology.

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Section: Discussionmentioning

confidence: 99%

Echocardiographic assessment of fetal cardiac function in the uterine artery ligation rat model of IUGR

et al. 2021

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“…The PTM, which was employed in this study, has been applied to clinical studies by many researchers, that is, noninvasive evaluation of the myocardial property of contraction and relaxation [5,30,31], elasticity of the arterial wall [32][33][34][35][36], and fatal cardiac or artery [7,8,37]. Although in this study, we reported only V ave during systolic time at the left ventricular septum, we hypothesize that the development of more detailed myocardial damaging process becomes clear by analyzing the continuous temporal relationship with V ave , V max , and color image.…”

Section: Discussionmentioning

confidence: 99%

“…Noninvasive early detection of anthracycline-induced cardiotoxicity in patients with hematologic malignancies using the phased tracking method micrometers up to several hundred Hertz, which has neither been recognized in TDI nor standard M-mode, B-mode, 2D-strain echocardiography. These fine measurement characteristics and the rapid minute amplitude have allowed measurement of the fetal heart and the fetal descending aorta of normal and growth-restricted fetuses [7,8].…”

Section: Original Researchmentioning

confidence: 99%

“…One such technique is the phased tracking method (PTM) , a high‐resolution Doppler measurement that is useful for detecting cardiac transmural changes , the PTM is measured on minute amplitude on the order of several tens of micrometers up to several hundred Hertz, which has neither been recognized in TDI nor standard M‐mode, B‐mode, 2D‐strain echocardiography. These fine measurement characteristics and the rapid minute amplitude have allowed measurement of the fetal heart and the fetal descending aorta of normal and growth‐restricted fetuses .…”

Section: Introductionmentioning

confidence: 99%

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Noninvasive early detection of anthracycline‐induced cardiotoxicity in patients with hematologic malignancies using the phased tracking method

et al. 2016

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Anthracyclines are among the most effective and widely used anticancer drugs; however, their use is limited by serious cardiotoxicity. Early detection is necessary to prevent the high mortality rate associated with heart failure (HF). We evaluated cardiac function in 142 patients using conventional echocardiography and the phased tracking method (PTM), which was measured using the minute vibration and the rapid motion components, neither of which is recognized in standard M‐mode nor in tissue Doppler imaging. For systolic function comparison, we compared left ventricular ejection fraction (LVEF) in conventional echocardiography with the average velocity of ventricular septum myocytes (Vave) in the PTM. The Vave of 12 healthy volunteers was 1.5 (m/s)/m or more. At baseline of 99 patients, there was a positive correlation between LVEF and Vave in all patients. There were no significant differences in baseline cardiac function between patients with and without HF. There was a negative correlation between the cumulative anthracycline dose and LVEF or Vave among all patients. We determined that Vave 1.5 (m/s)/m was equivalent to LVEF 60%, 1.25 (m/s)/m to 55%, and 1.0 (m/s)/m to 50%. During the follow‐up period, there was a pathological decrease in LVEF (<55%) and Vave (<1.25 m/s/m) in patients with HF; decreases in Vave were detected significantly earlier than those in LVEF (P < 0.001). When Vave declined to 1.5 (m/s)/m or less, careful continuous observation and cardiac examination was required. When Vave further declined to 1.0 (m/s)/m or lower, chemotherapy was postponed or discontinued; thus, serious drug‐induced cardiomyopathy was avoided in patients who did not relapse. The PTM was superior to echocardiography for early, noninvasive detection and intermediate‐term monitoring of left ventricle systolic function associated with anthracycline chemotherapy, among patients with hematologic malignancies. The PTM was an effective laboratory procedure to avoid the progression to serious cardiomyopathy.

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“…This concept is particularly relevant when applying these measurements to clinical practice in the assessment of fetal cardiac function for different pathologies [10,16,17]. …”

Section: Discussionmentioning

confidence: 99%

Comparison of Two Different Ultrasound Systems for the Evaluation of Tissue Doppler Velocities in Fetuses

et al. 2015

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Introduction: Recent studies have reported variations of up to 30% between different ultrasound machines for tissue Doppler imaging (TDI), a problem that can significantly impact clinical diagnosis, patient management and research studies. The objective of this study was to assess repeatability and agreement between fetal myocardial peak velocities evaluated by TDI with two different ultrasound systems. Materials and Methods: Systolic (S'), early (E') and late (A') diastolic myocardial peak velocities at mitral and tricuspid annuli as well as at the basal septum were evaluated by spectral TDI in 150 fetuses using two different ultrasound systems: Siemens Antares (Siemens Medical Systems, Malvern, Pa., USA) and Vivid Q (General Electric Healthcare, Horten, Norway). A method comparison study was performed, calculating intraclass correlation coefficients (ICC), and agreement was assessed by Bland-Altman plots. Results: Annular peak velocities showed lower values when measured by Vivid Q compared to values measured by Siemens Antares. ICC ranged from 0.07 (septal S') to 0.33 (right A'), showing very poor repeatability for clinical application. Agreement between the two systems was also poor, with high coefficients of variation for all measurements. Conclusions: Fetal annular peak velocities obtained with different ultrasound systems are not directly comparable. This is consistent with previous data in adults and warrants the need of system-specific reference values, suggesting that the same ultrasound machine should be used for longitudinal follow-up.

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Assessing Fetal Cardiac Function by Measuring Myocardial Radial Velocity Using the Phased-Tracking Method

Cited by 8 publications

References 25 publications

Echocardiographic assessment of fetal cardiac function in the uterine artery ligation rat model of IUGR

Echocardiographic assessment of fetal cardiac function in the uterine artery ligation rat model of IUGR

Noninvasive early detection of anthracycline‐induced cardiotoxicity in patients with hematologic malignancies using the phased tracking method

Comparison of Two Different Ultrasound Systems for the Evaluation of Tissue Doppler Velocities in Fetuses

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