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Quantitative Analysis of Morphology and Function in the Fetal Heart with Severe Tricuspid Regurgitation by Speckle Tracking Imaging

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Abstract

Morphology and function in a fetal heart with severe tricuspid regurgitation remains challenging. The aim of this study was to assess cardiac morphology and function in fetuses with severe tricuspid regurgitation by fetal heart quantification (HQ) and to assess the practical value of fetal HQ. Clinical information was analyzed for 63 pregnant women who underwent fetal cardiac ultrasonography. The women were divided into those who had a fetus with severe tricuspid regurgitation (n = 20) and those with a normal fetus (n = 40). The global sphericity index (GSI), fractional area change (FAC), and global longitudinal strain (GLS) of both ventricles and the sphericity index (SI) and fractional shortening (FS) of 24 segments were quantified by fetal HQ using speckle tracking imaging. Fetuses with severe tricuspid regurgitation had a significantly lower GSI (1.14 ± 0.10 vs. 1.26 ± 0.08, p < 0.001) and a higher GSI Z-score (-0.98 ± 1.01 vs. 0.25 ± 0.87, p < 0.001) as well as a significantly lower right ventricular FAC (36.50 ± 7.34% vs. 45.19 ± 3.39%, p < 0.001), FAC Z-score (-1.02 ± 1.41 vs. 0.49 ± 0.74, p < 0.001), and GLS (-21.01 ± 5.66% vs. 45.19 ± 3.49%, p < 0.001). The SI and SI Z-score were significantly lower in segments 1–18 of the right ventricle in fetuses with severe tricuspid regurgitation (p < 0.05); furthermore, FS of segments 1–12 and 19–24 and the FS Z-score of segments 18–24 were significantly lower in fetuses with severe tricuspid regurgitation (p < 0.05). Fetal HQ is useful for evaluation of cardiac morphology and function in fetuses with severe tricuspid regurgitation and can provide important reference information for both clinical diagnosis and treatment.

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All data generated or analyzed during this study are included in the article. Further enquiries can be directed to the corresponding author.

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Acknowledgements

We thank Liwen Bianji (Edanz) (www.liwenbianji.cn) for editing the English text of a draft of this manuscript.

Funding

This study was supported by General Cooperative Research Program of The Sci-Tech Academy of Zhejiang University (ZJU Cooperation No. 2021-KYY- 518053-0055).

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Authors and Affiliations

  1. Department of Diagnostic Ultrasound & Echocardiography, Sir Run Run Shaw Hospital, Zhejiang University College of Medicine, Hangzhou, 310016, China

    Yang Lou, Bowen Zhao, Mei Pan & Xiaohui Peng

  2. Special Inspection Section, Hangzhou Xixi Hospital, Hangzhou, 310023, China

    Yang Lou

  3. Shaoxing No.2 hospital, Shaoxing, 312099, China

    Lijian Huang

  4. Hangzhou Women’s Hospital, Zhejiang University, Hangzhou, 310016, China

    Xiaoxi Lu

  5. First People’s Hospital of Linping District, Hangzhou City, Hangzhou, 311201, China

    Xiaomin Zhang

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  1. Yang Lou
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Contributions

YL and BZ conducted the experiments and wrote the main manuscript. MP, LH, and XL analyzed the data and prepared figures. XZ and XP provided the experimental resources. All authors reviewed the manuscript.

Corresponding author

Correspondence to Bowen Zhao.

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Ethical Approval

The study protocol was reviewed and approved by ethics committee of Sir Run Run Shaw Hospital, Zhejiang University School of Medicine (approval number ZJSM-2020-0316).

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Written informed consent was obtained from all study participants.

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The authors declare that they have no conflicts of interest. All authors contributed to the article and approved the submitted version.

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Lou, Y., Zhao, B., Pan, M. et al. Quantitative Analysis of Morphology and Function in the Fetal Heart with Severe Tricuspid Regurgitation by Speckle Tracking Imaging. Pediatr Cardiol 45, 740–748 (2024). https://doi.org/10.1007/s00246-024-03454-4

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