Automated analysis of fetal cardiac function using color tissue Doppler imaging

Herling, Lotta; Johnson, Jonas; Ferm-Widlund, K.; Bergholm, Fredrik; Labas, P; Sonesson, Sven‐Erik; Acharya, Ganesh; Westgren, Magnus

doi:10.1002/uog.18812

Cited by 7 publications

(7 citation statements)

References 25 publications

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“…A composite adverse perinatal outcome was defined as the presence of at least one of the following: intrapartum fetal scalp blood lactate > 4.8 mmol/L, umbilical cord arterial pH < 7.15, 5-min Apgar score < 7 or 5-min Apgar score for muscle tone < 2. Data regarding the feasibility of automated analysis of fetal myocardial velocity measurements obtained by cTDI have been published previously using this cohort 16 .…”

Section: Methodsmentioning

confidence: 99%

Automated quantitative evaluation of fetal atrioventricular annular plane systolic excursion

Herling

Johnson

Ferm-Widlund

et al. 2021

Ultrasound in Obstet & Gyne

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Section: Methodsmentioning

confidence: 99%

Automated quantitative evaluation of fetal atrioventricular annular plane systolic excursion

Herling

Johnson

Ferm-Widlund

et al. 2021

Ultrasound in Obstet & Gyne

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“…Despite limitations, cTDI is a promising method for assessing fetal cardiac function. However, its routine clinical application is hampered by a cumbersome and time-consuming off-line analysis that has been partly solved through the use of an automated analysis of myocardial velocities [15][16][17].…”

Section: Introductionmentioning

confidence: 99%

Fetal cardiac function at intrauterine transfusion assessed by automated analysis of color tissue Doppler recordings

Herling

Johnson

Ferm-Widlund

et al. 2020

Cardiovasc Ultrasound

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Background: Fetal anemia is associated with a hyperdynamic circulation and cardiac remodeling. Rapid intrauterine transfusion (IUT) of blood with high hematocrit and viscosity into the umbilical vein used to treat this condition can temporarily further affect fetal heart function. The aim of this study was to evaluate the short-term changes in fetal myocardial function caused by IUT using automated analysis of cine-loops of the fetal heart obtained by color tissue Doppler imaging (cTDI). Methods: Fetal echocardiography was performed before and after IUT. cTDI recordings were obtained in a fourchamber view and regions of interest were placed at the atrioventricular plane in the left ventricular (LV), right ventricular (RV) and septal walls. Myocardial velocities were analyzed by an automated analysis software to obtain peak myocardial velocities during atrial contraction (Am), ventricular ejection (Sm), rapid ventricular filling (Em) and Em/Am ratio was calculated. Myocardial velocities were converted to z-scores using published reference ranges. Delta z-scores (after minus before IUT) were calculated. Correlations were assessed between variables and hemoglobin before IUT. Results: Thirty-two fetuses underwent 70 IUTs. Fourteen were first time transfusions. In the LV and septal walls, all myocardial velocities were significantly increased compared to normal values, whereas in the RV only Sm was increased before IUT (z-scores 0.26-0.52). In first time IUTs, there was a negative correlation between LV Em (rho = − 0.61, p = 0.036) and LV Em/Am (rho = − 0.82, p = 0.001) z-scores and hemoglobin before IUT. The peak myocardial velocities that were increased before IUT decreased, whereas LV Em/Am increased significantly after IUT. Conclusions: This study showed that peak myocardial velocities assessed by cTDI are increased in fetuses before IUT reflecting the physiology of hyperdynamic circulation. In these fetuses, the fetal heart is able to adapt and efficiently handle the volume load caused by IUT by altering its myocardial function.

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“…This study shows that it is possible to use an automated algorithm to facilitate the analysis of myocardial velocity traces obtained by cTDI in order to evaluate fetal cardiac function throughout the second half of pregnancy, as has been shown previously for term fetuses. We provide reference ranges adjusted to GA for peak myocardial velocities, Em/Am ratios, mechanical cardiac time intervals and cMPI, all calculated using the automated method.…”

Section: Discussionmentioning

confidence: 87%

“…However, the offline analysis of myocardial velocity traces generated using cTDI cine-loops is cumbersome and time-consuming, and there is a need to improve and simplify the analysis. Our group has demonstrated previously the feasibility of an automated algorithm for the analysis of cTDI myocardial velocity traces 16 and used this to evaluate fetal cardiac function in postdates pregnancies 17 . In the present study, we hypothesized that automated analysis could be used throughout the second half of pregnancy to measure parameters describing fetal cardiac function.…”

mentioning

confidence: 99%