Wall motion tracking in fetal echocardiography—Application of low and high frame rates for strain analysis

Abstract

Objective: Compared to adults, fetal heart rates (HR) are elevated necessitating higher frame rates (FR) for strain analysis by speckle tracking echocardiography. The aim of this study was to investigate the influence of high FR compared to low FR on strain analysis in 2D speckle tracking. Methods: Fetal echocardiography was prospectively performed and acquired from the apical or basal four-chamber views of the heart. Images were optimized for clear delineation of myocardial walls and stored in either raw Digital Imaging and Communications in Medicine (DICOM) cine-loop format for offline analysis with a low FR of 60 frames per second (fps) or in the original FR (acoustic FR = AFR). For each loop, right (RV) and left (LV) ventricular fetal longitudinal peak systolic strain (LPSS) values were assessed by 2D Wall Motion tracking.Results: One hundred and three healthy fetuses were included with a mean gestational age of 26.3 ± 5.5 weeks. Mean AFR was 127 ± 26 fps. A mean FR/HR ratio was assessed of 0.42 and 0.90 between the low FR and AFR group, respectively. Relating to LPSS values, there was a significant difference between low FR and AFR for both ventricles (LV: −16.5% ± 3.9% (low FR) vs −13.6% ± 3.5% (AFR); and RV: −15.1% ± 3.6% (low FR) vs −12.6% ± 3.7% (AFR), both P < 0.001). Conclusions: Fetal LV and RV LPSS values derived with high AFR were significantly lower than corresponding LPSS values analyzed with low FR of 60 fps. Future studies are needed to clarify the clinical importance of this relationship. K E Y W O R D S fetal echocardiography, myocardial strain, wall motion How to cite this article: Enzensberger C, Rostock L, Graupner O, et al. Wall motion tracking in fetal echocardiography-Application of low and high frame rates for strain analysis.

Induction of left ventricular hypoplasia by occluding the foramen ovale in the fetal lamb

“…In one fetus, data on myocardial tissue deformation (strain) were collected immediately before and after FO closure using 2D speckle tracking for both ventricles (Aplio 500 system, Toshiba Medical Systems Corporation, Tochigi, Japan), equipped with a 1-5 MHz curved array probe (PVT 375 BT) as we previously described [29][30][31] . We assessed global longitudinal peak systolic strain (LPSS) for both ventricles in the fetal lamb as previously described [29][30][31] . The frame rate for analysis was 60 fps.…”

Atrial and Ventricular Deformation Analysis in Normal Fetal Hearts Using Two-Dimensional Speckle Tracking Echocardiography

“…We retrospectively analyzed prospectively acquired data on healthy fetuses between the 16th and 39th week of gestation selected from women referred for fetal echocardiography from April 2014 to March 2016. Some of these fetuses were reported in previous studies [10][11][12].…”

“…However, reported ventricular strain values for mean LV and RV global longitudinal peak systolic strain (LPSS) show a widespread ranging [8,10,[13][14][15][16][17]. Our own work revealed that the variability in image acquisition, optimal temporal resolution, and use of different ultrasound software packages are important influencing factors and possible reasons for this divergent strain values [10][11][12]. On the other hand, data on fetal myocardial deformation properties of the left atrium (LA) and right atrium (RA) are sparse [18,19].…”

“…has gained greater acceptance, as it has shown to be feasible and reproducible for the assessment of both right ventricular (RV) and left ventricular (LV) performance in the fetus [5][6][7][8][9][10][11][12]. However, reported ventricular strain values for mean LV and RV global longitudinal peak systolic strain (LPSS) show a widespread ranging [8,10,[13][14][15][16][17].…”

“…According to our previous studies [10,12], fetal echocardiography was performed standardized by a highly experienced operator on a Toshiba Aplio 500 ultrasound system (Toshiba Medical Systems Corporation, Otawara, Tochigi, Japan) with a 1-5 MHz curved array probe (PVT 375 BT). Based on practical knowledge of previous data acquisitions, B-mode image depth was reduced, sector width was adjusted, and fetal as well as maternal movements were avoided to guarantee high-quality image acquisition with the aim to display every cardiac cavity in their full size.…”