TY - JOUR
T1 - Second trimester ultrasound
T2 - Reference values for two-dimensional speckle tracking-derived longitudinal strain, strain rate and time to peak deformation of the fetal heart
AU - Kapusta, Livia
AU - Mainzer, Gur
AU - Weiner, Zeev
AU - Deutsch, Lisa
AU - Khoury, Asaad
AU - Haddad, Sami
AU - Lorber, Avraham
PY - 2012/12
Y1 - 2012/12
N2 - Background: Data on myocardial deformation during the internationally widely used second-trimester screening are scarce and confusing. Reference values of time to peak strain are missing. The aims of this study were to assess reference values derived from two-dimensional speckle-tracking echocardiography for global and regional longitudinal right ventricular (RV) and left ventricular (LV) strain, strain rate, and time to peak global strain and to determine the influence of heart rate and gender on these strain parameters. Methods: Seventy-five healthy fetuses were enrolled during second-trimester ultrasound (20-24 weeks). Clips with high frame rates (mean, 132 frames/sec) and two-dimensional (B-mode) grayscale images of apical or basal four-chamber views of both ventricles were used for offline analyses. Results: There were no statistically significant differences in global strain and strain rate between both ventricles (P =.679 and P =.734, respectively) or among the RV, septal, and LV free walls. Regional measurements, modeled also as an interaction of wall and segment (basal mid and apical), showed only a small, statistically significant difference between the basal RV and LV free walls. Strain and strain rate values were independent of heart rate. The mean time to peak LV global strain adjusted for heart rate was statistically significantly shorter than the RV value (P <.0001]). Strain, strain rate, and time to peak global strain were not found to be associated with gender. Conclusions: The establishment of second-trimester two-dimensional speckle-tracking echocardiographic reference values for global and regional strain, strain rate, and time to peak global strain in a healthy fetal cohort is a mandatory prerequisite for its use in evaluating (pathologic) changes in both ventricular functions during pregnancy.
AB - Background: Data on myocardial deformation during the internationally widely used second-trimester screening are scarce and confusing. Reference values of time to peak strain are missing. The aims of this study were to assess reference values derived from two-dimensional speckle-tracking echocardiography for global and regional longitudinal right ventricular (RV) and left ventricular (LV) strain, strain rate, and time to peak global strain and to determine the influence of heart rate and gender on these strain parameters. Methods: Seventy-five healthy fetuses were enrolled during second-trimester ultrasound (20-24 weeks). Clips with high frame rates (mean, 132 frames/sec) and two-dimensional (B-mode) grayscale images of apical or basal four-chamber views of both ventricles were used for offline analyses. Results: There were no statistically significant differences in global strain and strain rate between both ventricles (P =.679 and P =.734, respectively) or among the RV, septal, and LV free walls. Regional measurements, modeled also as an interaction of wall and segment (basal mid and apical), showed only a small, statistically significant difference between the basal RV and LV free walls. Strain and strain rate values were independent of heart rate. The mean time to peak LV global strain adjusted for heart rate was statistically significantly shorter than the RV value (P <.0001]). Strain, strain rate, and time to peak global strain were not found to be associated with gender. Conclusions: The establishment of second-trimester two-dimensional speckle-tracking echocardiographic reference values for global and regional strain, strain rate, and time to peak global strain in a healthy fetal cohort is a mandatory prerequisite for its use in evaluating (pathologic) changes in both ventricular functions during pregnancy.
KW - 2DSTE
KW - Fetal
KW - Myocardial deformation
KW - Second-trimester ultrasound
KW - Strain
KW - Two-dimensional speckle-tracking echocardiography
UR - http://www.scopus.com/inward/record.url?scp=84870279135&partnerID=8YFLogxK
U2 - 10.1016/j.echo.2012.09.011
DO - 10.1016/j.echo.2012.09.011
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C2 - 23200418
AN - SCOPUS:84870279135
SN - 0894-7317
VL - 25
SP - 1333
EP - 1341
JO - Journal of the American Society of Echocardiography
JF - Journal of the American Society of Echocardiography
IS - 12
ER -