Evolution of Fetal Cardiac Imaging over the Last 20 Years

Magioli Bravo-Valenzuela, Nathalie Jeanne; Malho, André Souza; Nieblas, Caroline de Oliveira; Castro, Pedro Teixeira; Werner, Heron; Araujo Júnior, Edward

doi:10.3390/diagnostics13233509

Cited by 2 publications

(1 citation statement)

References 57 publications

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“…Therefore, extensive training and education of future experts is of enormous significance 48–51 . Applications based on artificial intelligence (AI), on whose algorithms prenatal diagnostics will rely increasingly, are transforming the way clinicians use ultrasound 50,52–65 …”

Section: Introductionmentioning

confidence: 99%

How automated techniques ease functional assessment of the fetal heart: Applicability of two‐dimensional speckle‐tracking echocardiography for comprehensive analysis of global and segmental cardiac deformation using fetalHQ®

Scharf,

Dracopoulos,

Gembicki

et al. 2024

Echocardiography

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BackgroundPrenatal echocardiographic assessment of fetal cardiac function has become increasingly important. Fetal two‐dimensional speckle‐tracking echocardiography (2D‐STE) allows the determination of global and segmental functional cardiac parameters. Prenatal diagnostics is relying increasingly on artificial intelligence, whose algorithms transform the way clinicians use ultrasound in their daily workflow. The purpose of this study was to demonstrate the feasibility of whether less experienced operators can handle and might benefit from an automated tool of 2D‐STE in the clinical routine.MethodsA total of 136 unselected, normal, singleton, second‐ and third‐trimester fetuses with normofrequent heart rates were examined by targeted ultrasound. 2D‐STE was performed separately by beginner and expert semiautomatically using a GE Voluson E10 (FetalHQ®, GE Healthcare, Chicago, IL). Several fetal cardiac parameters were calculated (end‐diastolic diameter [ED], sphericity index [SI], global longitudinal strain [EndoGLS], fractional shortening [FS]) and assigned to gestational age (GA). Bland‐Altman plots were used to test agreement between both operators.ResultsThe mean maternal age was 33 years, and the mean maternal body mass index prior to pregnancy was 24.78 kg/m2. The GA ranged from 16.4 to 32.0 weeks (average 22.9 weeks). Averaged endoGLS value of the beginner was ‐18.57% ± 6.59 percentage points (pp) for the right and ‐19.58% ± 5.63 pp for the left ventricle, that of the expert ‐14.33% ± 4.88 pp and ‐16.37% ± 5.42 pp. With increasing GA, right ventricular endoGLS decreased slightly while the left ventricular was almost constant. The statistical analysis for endoGLS showed a Bland‐Altman‐Bias of ‐4.24 pp ± 8.06 pp for the right and ‐3.21 pp ± 7.11 pp for the left ventricle. The Bland‐Altman‐Bias of the ED in both ventricles in all analyzed segments ranged from ‐.49 mm ± 1.54 mm to ‐.10 mm ± 1.28 mm, that for FS from ‐.33 pp ± 11.82 pp to 3.91 pp ± 15.56 pp and that for SI from ‐.38 ± .68 to ‐.15 ± .45.ConclusionsBetween both operators, our data indicated that 2D‐STE analysis showed excellent agreement for cardiac morphometry parameters (ED and SI), and good agreement for cardiac function parameters (EndoGLS and FS). Due to its complexity, the application of fetal 2D‐STE remains the domain of scientific‐academic perinatal ultrasound and should be placed preferably in the hands of skilled operators. At present, from our perspective, an implementation into clinical practice “on‐the‐fly” cannot be recommended.

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Section: Introductionmentioning

confidence: 99%

How automated techniques ease functional assessment of the fetal heart: Applicability of two‐dimensional speckle‐tracking echocardiography for comprehensive analysis of global and segmental cardiac deformation using fetalHQ®

Scharf,

Dracopoulos,

Gembicki

et al. 2024

Echocardiography

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Incidence and Antenatal Detection of Congenital Heart Malformations—Data from a Tertiary Obstetric Romanian Center

Ciulpan,

Lacatușu,

Pop

et al. 2024

Diagnostics

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Objectives: Congenital heart defects (CHDs) are among the most frequent congenital defects, and they significantly burden the healthcare system due to their high mortality rate and high cost of care for survivors. We aimed to highlight the incidence of CHDs in a tertiary center in Western Romania. Methods: A retrospective study was carried out between 2018 and 2022 at the “Pius Brinzeu” Emergency County Hospital Timisoara. Relevant information about the mothers and the newborns were collected and statistically analyzed. Results: The incidence of CHDs from 2018 to 2022 in our center was 5.3%. Eleven types of malformations were diagnosed postnatally in 541 newborns, with 28.8% of cases having more than one type of CHD. The antenatal detection rate was 28%, with the highest rates for tetralogy of Fallot, hypoplastic left heart syndrome, or significant ventricular septal defects and the lowest for pulmonary stenosis. The lower antenatal detection rate was influenced mainly by incomplete or absent prenatal care. Conclusions: The incidence of CHDs is clearly dependent of a multifactorial approach, and the results highlight this. With an incidence almost 50% lower than reported within the literature and a low rate of prenatal detections, CHDs could be a more of a burden to endure regarding medical treatment. Improvements in patients’ education, prenatal care, and screening programs could improve diagnosis, decrease mortality, and optimize postnatal care.

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Evolution of Fetal Cardiac Imaging over the Last 20 Years

Cited by 2 publications

References 57 publications

How automated techniques ease functional assessment of the fetal heart: Applicability of two‐dimensional speckle‐tracking echocardiography for comprehensive analysis of global and segmental cardiac deformation using fetalHQ®

How automated techniques ease functional assessment of the fetal heart: Applicability of two‐dimensional speckle‐tracking echocardiography for comprehensive analysis of global and segmental cardiac deformation using fetalHQ®

Incidence and Antenatal Detection of Congenital Heart Malformations—Data from a Tertiary Obstetric Romanian Center

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