Functional assessment of the fetal heart: a review

Abstract

ABSTRACT

Assessment of Cardiac Dysfunction in the Intrauterine Growth-restricted Fetuses from Pre-eclamptic Mothers

“…All the techniques used bear the shortcoming that, even though they may strongly imply the presence of cardiac dysfunction, they do not necessarily pinpoint the etiology or the causal mechanism. 8,9 As such, these techniques seem more appropriate for surveillance of cases with a formerly known pathology, which is the case in our study series. Our study aimed to assess the cardiac function in a series of IUGR fetuses from preeclamptic mothers by both conventional ultrasound and TDI.…”

The development of, and future for, fetal functional cardiac imaging techniques

“…Numerous parameters have been proposed to quantify fetal cardiac function, from measurements including Doppler flow mapping, heart biometry and timing of cardiac events 2 . The basis of many of the novel indices of fetal cardiac function include techniques familiar to most fetal medicine practitioners and cardiologists such as pulsed wave, 5 M‐mode, 6 and tissue Doppler 7 as well as the relatively new technique of speckle tracking 8 .…”

“…When these individual points are followed, it is possible to evaluate the overall deformation of the myocardium, and when a time integral is introduced this generates velocity vectors, that can be used to calculate displacement, velocity, deformation (strain) and velocity of deformation (strain rate) in the cardiac wall 9 . Readers are directed to a number of extensive reviews of techniques for evaluating fetal cardiac function, 2 , 10 one of which was contained within a focussed fetal cardiac function edition of the journal Fetal Diagnosis and Therapy from 2012 that can be accessed at the following location: http://www.karger.com/Book/Home/257215.…”

Re: Fetal right ventricular contraction and relaxation times at 11–13 weeks' gestation by speckle tracking imaging

“…in fetal anemia; recipients in twin-twin transfusion syndrome; intrauterine growth restriction), an increasing amount of time is required to build up enough ejection force to open the atrioventricular valves (isovolumetric contraction time, ICT) and/or to relax after blood ejection has been achieved (isovolumetric relaxation time, IRT) 2 . The myocardial performance index (MPI, or 'Tei index') is the sum of ICT and IRT divided by the ejection time (ET) and is one of the most well-established parameters to analyze global ventricular function 3 . In fetuses with myocardial dysfunction, the main parameter of the MPI being affected is the IRT, which is increased, accompanied by a reduction in ET 4 .…”