Abstract
BackgroundPresent data regarding how the fetal heart works and develops throughout gestation is limited. However, the possibility to analyze the myocardial velocity profile provides new possibilities to gain further knowledge in this area. Thus, the objective of this study was to evaluate human fetal myocardial characteristics and deformation properties using color-coded tissue velocity imaging (TVI).MethodsTVI recordings from 55 healthy fetuses, at 18 to 42 weeks of gestation, were acquired at a frame rate of 201–273 frames/s for offline analysis using software enabling retrieval of the myocardial velocity curve and 2D anatomical information. The measurements were taken from an apical four-chamber view, and the acquired data was correlated using regression analysis.ResultsLeft ventricular length and width increased uniformly with gestational age. Atrioventricular plane displacement and the E’/A’ ratio also increased with gestational age, while a longitudinal shortening was demonstrated.ConclusionsFetal cardiac muscle contractility decreases with gestational age. As numerous fetal- and pregnancy-associated conditions directly influence the pumping function of the fetal heart, we believe that this new insight into the physiology of the human fetal cardiovascular system could contribute to make diagnosis and risk assessment easier and more accurate.
Highlights
Recent findings demonstrate changes in cardiac muscle contractility in the sheep fetus explained by changes in cardiac troponins with gestational age [1]
There is limited data regarding the functional properties of the human fetal myocardium, and how the human fetal heart works and develops throughout gestation
The left ventricular (LV) length increased from 7–12 mm at 18 weeks of gestation to 27–32 mm at term (r = 0.946), and the LV width increased from 4–5 mm at 18 weeks of gestation to 10–16 mm at term (r = 0.851)
Summary
Recent findings demonstrate changes in cardiac muscle contractility in the sheep fetus explained by changes in cardiac troponins with gestational age [1]. There is limited data regarding the functional properties of the human fetal myocardium, and how the human fetal heart works and develops throughout gestation. The possibility to analyze the myocardial velocity profile provides new possibilities to gain further. The general objective of this study was to evaluate fetal myocardial characteristics and deformation properties using TVI. Evaluating the contractile function and atrioventricular (AV) plane displacement, with the intention to learn if cardiac muscle contractility in the human fetus, as in the sheep fetus, change with gestational age. The possibility to analyze the myocardial velocity profile provides new possibilities to gain further knowledge in this area. The objective of this study was to evaluate human fetal myocardial characteristics and deformation properties using color-coded tissue velocity imaging (TVI)
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