Cardiac Size, Shape, and Ventricular Contractility in Fetuses at Sea Level With an Estimated Weight Less‐than 10th Centile

Abstract

Objectives-To investigate cardiac size, shape, and ventricular contractility in fetuses with estimated fetal weight (EFW) <10th centile at sea level (Houston).Methods-A prospective ultrasound study examined 37 fetuses with EFW <10th centile at sea level. High-frequency cine clips were used to evaluate the 4-chamber view including end-diastolic measurements and global sphericity index. The size, shape, and contractility of both ventricles were analyzed with speckle tracking methods. Z scores were calculated using the mean AE standard deviation (SD) derived from normal controls. Measurements were abnormal if their Z score values were <À1.65 or >+1.65. The proportion of small fetuses with abnormal parameters was compared to normal reference ranges. Results were compared to a similar published study of small fetuses at higher altitude in Denver.Results-About one-third of Houston fetuses with EFW <10th centile had enlarged globular shaped 4-chamber hearts with increased right ventricle (RV) area, RV basal-apical length, RV base width, and left ventricle (LV) basalapical length measurements. Bilateral ventricular hypertrophy was often present. An increased proportion of Houston fetuses had increased ventricular contractility. However, decreased ventricular contractility was more prevalent for higher altitude fetuses.Conclusions-Third trimester fetuses at sea level, with an EFW <10th centile, were often associated with enlarged and globular-shaped hearts. They had increased global and longitudinal ventricular contractility as compared to controls. Higher altitude fetuses also had enlarged globular-shaped hearts but with a greater proportion of cases having decreased ventricular contractility as compared to the sea level cohort.

Evaluation of fetal cardiac function in fetal growth restriction via fetal HQ analysis based on two‐dimensional STI

“…The normal value range and Z score were set up and were convenient for further research. [27][28][29][30][31] In this study, the reduction of RVFAC and RVGLS indicate reduction of the RV systolic function in both the early and late FGR groups. Also, the numbers of segmental motion abnormalities of RV were higher than those of the LV, which were considered to be related to fetal atelectasis and special cardiac anatomical structures and channels.…”

“…Devore et al had made breakthrough using fatal HQ technology to evaluate the cardiac function of FGR fetuses, including the local cardiac function. The normal value range and Z score were set up and were convenient for further research 27–31 . In this study, the reduction of RVFAC and RVGLS indicate reduction of the RV systolic function in both the early and late FGR groups.…”