P08.09: Annular plane systolic excursion z‐scores in evaluation of ventricle systolic function of fetuses with Ebstein's anomaly

Abstract

To establish z-score models for fetal tricuspid annular plane systolic excursion (TAPSE) and mitral annular plane systolic excursion (MAPSE) based on gestational age (GA), and to evaluate both ventricle systolic function of fetuses with Ebstein's anomaly (EA). 1024 normal fetuses and 25 fetuses with EA were involved. TAPSE and MAPSE were measured by free angle M-mode echocardiography (FAM), Normal FAM-TAPSE and FAM-MAPSE models were constructed based on GA by performing a standard regression analysis followed by weighted regression of absolute residual values. FAM-TAPSE z-scores, FAM-MAPSE z-scores and mitral valve-tricuspid valve distance (MTD) between the normal and EA groups were compared in ANOVA. The following ratios were calculated: functional right ventricle arae (FRV) to cardiac area (CA), atrialised right ventricle area (ARV) to CA, ARV to FRV and MTD to cardiac axial length (CAL), and regression equation estimate was used to compare the relationship of FAM-TAPSE z-scores with MDT/CAL, FRV/CA, ARV/CA and ARV/FRV. The models used to calculate z-scores for FAM-TAPSE and FAM-MAPSE were constructed, and GA was significantly correlated with them. Compared with normal fetuses, the mean z-scores of FAM-TAPSE, FAM-MAPSE and MTD were statistically significantly different between normal fetuses and those with EA, In the EA group, all FAM-TAPSE z-scores (25/25) were <−2, However, only 36% (9/25) of the FAM-MAPSE z-scores were <−2. FAM-TAPSE z-scores showed positive correlations with MDT/CAL, FRV/CA, ARV/CA and ARV/FRV. The FAM-TAPSE z-scores declined in fetuses with EA as the increasing areas of atrialised right ventricle and MTD, they can provide quantitative evidence in evaluation of right heart systolic function, FAM-MAPSE z-scores can aslo assess the impaired degree of left ventricle function affected by right ventricle. FAM-TAPSE and FAM-MAPSE z-score would be markers for assessing ventricle function in fetuses with EA, and provide help to the prognosis and the perinatal management.