Fetal Diagnosis and Therapy

Domínguez-Gallardo C.a,b,c· Ginjaume-García N.a,b· Ullmo J.a,b,c· Trilla C.a,b,c,d· Medina M.C.a,b,c· Vázquez A.e· Cruz-Lemini M.a,b,c,d· Llurba E.a,b,c,d

Author affiliations

aObstetrics and Gynecology Department, Santa Creu i Sant Pau Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain
bWomen and Perinatal Health Research Group, Sant Pau Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain
cMaternal and Child Health and Development Network (SAMID), RD16/0022, Instituto de Salud Carlos III, Madrid, Spain
dPrimary Care Interventions to Prevent Maternal and Child Chronic Diseases of Perinatal and Developmental Origin Network (RICORS, RD21/0012/0001), Instituto de Salud Carlos III, Madrid, Spain
eApplied Statistics Department, Universitat Autònoma de Barcelona, Barcelona, Spain

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Article / Publication Details

Received: May 17, 2022
Accepted: September 14, 2022
Published online: September 20, 2022

Number of Print Pages: 10
Number of Figures: 2
Number of Tables: 4

ISSN: 1015-3837 (Print)
eISSN: 1421-9964 (Online)

For additional information: https://www.karger.com/FDT

Abstract

Introduction: The objective of this study was to construct gestational age (GA) based reference values for left ventricle (LV) longitudinal strain in normal fetuses, between 24 and 37 weeks’ gestation, assessing its feasibility and reproducibility with automated cardiac motion quantification software (aCMQ-QLab), which is widely used in postnatal echocardiography. Methods: This prospective study included healthy gravid women with singleton pregnancies and no evidence of fetal structural cardiovascular disease. Fetal echocardiographies were performed between 24 and 37 GA. 2D four-chamber view clips were recorded and LV longitudinal strain was analyzed offline. Intra- and interobserver reproducibility between 2 independent observers was evaluated by intraclass correlation coefficients (ICC) and Bland-Altman scatterplots. Regression analysis was used to determine GA adjusted reference ranges and construct nomograms. Results: LV longitudinal strain measurements were feasible in 95.4% of acquisitions. 435 clips were obtained. Intra- and interobserver ICC were 0.998 (95% CI 0.997–0.999) and 0.991 (95% CI 0.984–0.995), respectively. The global longitudinal strain and the middle and apical LV segments showed progressive decline as GA advanced, whereas the basal segments remained stable. Conclusions: Assessment of LV longitudinal strain by aCMQ-QLab is feasible, reproducible, and within normal ranges. Our results offer more information regarding fetal cardiac function assessment with 2D speckle tracking techniques, aiding in the introduction of this software into research practice, encouraging the realization of more studies, and probably helping in its future use in clinical practice, allowing longitudinal surveillance of strain without intervendor variability and aiding in follow-up of fetal cardiac conditions before and after birth, as it is the most commonly used software postnatally.

© 2022 S. Karger AG, Basel

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Received: May 17, 2022
Accepted: September 14, 2022
Published online: September 20, 2022

Number of Print Pages: 10
Number of Figures: 2
Number of Tables: 4

ISSN: 1015-3837 (Print)
eISSN: 1421-9964 (Online)

For additional information: https://www.karger.com/FDT

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