European Journal of Echocardiography Advance Access originally published online on April 28, 2008
European Journal of Echocardiography 2008 9(6):754-756; doi:10.1093/ejechocard/jen134
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Two-dimensional strain to assess regional left and right ventricular longitudinal function in 100 normal foetuses
1 Pediatric Cardiology Department, Second University of Naples, INBB Research Unit, Via Omodeo 45, Naples 80128, Italy
2 Prenatal Diagnosis Unit, Department of Gynecology and Obstetrics, University Federico II of Naples, Naples, Italy
3 Department of Gynecology and Obstetrics, Second University of Naples, Naples, Italy
Received 6 January 2008; accepted after revision 2 March 2008; online publish-ahead-of-print 28 April 2008.
* Corresponding author. Tel: +39 081 193 638 51; fax: +39 081 560 56 48. E-mail address: giodisal{at}yahoo.it
 |
Abstract |
|---|
Aims: Previous reports have demonstrated that myocardial velocities are not sufficiently sensitive in foetal heart studies. Strain (S) imaging is a new non-invasive ultrasonic technique able to quantify regional myocardial deformation properties. Strain imaging has a superior sensitivity than myocardial velocity for non-invasive assessment of ventricular function. However, Doppler-derived strain imaging has been used to quantify myocardial deformation properties in the foetal heart with rather limited results, because of angle dependency, sensitivity to extracardial movement, the need for good-quality images, long and time-consuming post-processing and the low reproducibility of Doppler-derived strain.
Recently, a novel method for motion estimation based on two-dimensional (2D) tissue tracking strain (2D-S) echocardiography using time-domain processing has been developed, providing rapid assessment of regional myocardial strain that is independent of both cardiac translation and angle dependency, with a very good reproducibility.
However, no information on 2D-S in human foetuses has so far been provided.
Methods: We studied 100 consecutive normal foetuses (gestation range: 20–32 weeks; no evidence of structural cardiovascular disease by 2D echo and Doppler study) using 2D-S imaging. Left ventricle (LV) and right ventricle (RV) peak myocardial negative strain values were obtained.
Results: Strain data were obtained from all the studied subjects, the duration of post processing was 3 ± 2 min for each patient dataset. Peak longitudinal deformation parameters were homogeneous in all the three studied walls (strain: septum = –25 ± 5%; lateral wall = –25 ± 4%; RV free wall = –24 ± 4%; P = NS). There were significant correlations between gestational age and peak longitudinal strain (P < 0.001; R: –0.73). Inter and intra-observer variability for strain was good, <3 and <6%, respectively.
Conclusion: This study demonstrated that 2D-S is a feasible and reproducible approach to assess regional ventricular function in the foetal heart, ready for the clinical application.
Keywords: Strain rate imaging; Foetal heart; Echocardiography