Assessment of Fetal Global and Regional Ventricular Function in Congenital Heart Disease Using a Novel Feature Tracking Technique

Abstract

The aim of this study was to assess global and regional longitudinal peak systolic ventricular function in fetuses with congenital heart disease (CHD) and compare measurements derived from feature tracking with reference values of healthy fetuses with a matching gestational age. Global and segmental longitudinal peak systolic strain (LPSS), strain rate and velocity values of the left (LV) ventricular myocardium and right (RV) ventricular myocardium were assessed by a novel feature tracking technique in 17 fetuses with congenital heart disease (10 fetuses with left heart obstruction (LHO), 5 fetuses with tetralogy of Fallot (TOF) and 2 fetuses with double outlet right ventricle (DORV)) and were compared in a second step with 24 matched healthy fetuses (gestational age range 21-36 weeks of gestation). The global LPSS of both ventricles was slightly elevated in fetuses with TOF or DORV compared with controls (RV: p=0.055; LV: p=0.063). The RV strain rate presented a trend toward higher values (p=0.09). Corresponding global LV velocity values of fetuses with TOF or DORV revealed a tendency to decrease compared to healthy controls (p=0.054). In contrast, all measurements of fetuses with LHO did not show any statistical difference regarding deformation parameters or velocity compared to healthy controls. Global longitudinal peak systolic measurements in fetuses with congenital heart disease revealed slightly higher strain (RV/LV) and strain rate (RV) values in the subgroup of fetuses with TOF or DORV compared to healthy controls. Whether the application of this new angle-independent technique is suitable for discriminating between healthy and diseased fetuses has to be verified in further investigations.