Ventricular Free Wall and Septal Wall Displacement of the Fetal Heart

IF 2.1 4区医学 Q2 ACOUSTICS

Journal of Ultrasound in Medicine Pub Date : 2025-03-07 DOI:10.1002/jum.16673

Greggory R. DeVore MD, Berthold Klas BS, Gary Satou MD, Mark Sklansky MD

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引用次数: 0

Abstract

Objective

The purpose of this study was to measure the systolic displacement of the free and septal walls of the right (RV) and left (LV) ventricles using speckle tracking analysis in normal fetuses and those with cardiac abnormalities.

Methods

Two-hundred fetuses between 20 and 40 weeks of gestation were examined in which the 4-chamber view (4CV) of the fetal heart was imaged. Speckle tracking analysis of the RV and LV was used to measure the length of displacement between end-diastole and end-systole for each of 24 segments located on the free and septal walls from the base to the apex of each ventricle. The mean displacement length was computed for the base (segments 1–8), mid-chamber (segments 9–16), and the apex (segments 17–24) of the RV and LV free walls (RVfw, LVfw) and septal walls (RVsw, LVsw). Fractional polynomial regression analysis was used to compute the mean equation for the base, mid-chamber, and apex displacement lengths for the RV and LV free walls and septal walls using gestational age as the independent variable. The Kruskal–Wallis test with a Bonferroni correction was used to compare the mean values from the base, mid-chamber, and apex segments between the RVfw versus RVsw, LVfw versus LVsw, RVfw versus LVfw, and RVsw versus LVsw. In addition, the ultrasound program provided a graphic of the systolic segment length of the RV and LV free walls and septal walls. Four examples of cardiac pathology were used to illustrate abnormal free and septal wall segment displacement.

Results

The mean segment end-systolic displacement lengths for the RVfw (base and mid-chamber), and LVfw (base, mid-chamber, and apex) increased with gestational age. However, The RVsw and LVsw segment lengths did not increase or increased minimally as a function of gestational age. The displacement lengths for the RVfw versus RVsw and LVfw versus LVsw were greater for the free wall than the septal wall for the base, mid-chamber, and apex. When comparing the RV with the LV, the segment lengths for the RVfw were significantly greater than the LVfw for the base. The segment lengths were significantly greater for the LVsw than the RVsw for the base, mid-chamber, and apex. The LVsw segments moved inward toward the LV chamber for the mid-chamber and apex. For the RVsw, the segment lengths moved between both the RV and LV chamber during systole. Four pathological cases graphically illustrated abnormal movement of the RVfw, LVfw, RVsw, and LVsw.

Conclusion

Speckle tracking analysis enabled quantitation of the systolic ventricular free wall and septal wall segment displacement as well as a graphical display of displacement that can be used to identify pathological changes when abnormal cardiac function is present.

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胎儿心脏心室游离壁和间隔壁位移：定量和定性评估。

目的：本研究的目的是利用斑点跟踪分析测量正常胎儿和心脏异常胎儿右心室（RV）和左心室（LV）自由壁和间隔壁的收缩位移。方法：对200例妊娠20 ~ 40周的胎儿进行心脏四腔位（4CV）成像。采用斑点跟踪法对左室和左室进行分析，测量位于自由室壁和间隔室壁上的每24段从心室基部到顶点的舒张末期和收缩末期之间的位移长度。计算左室和左室自由壁（RVfw, LVfw）和间隔壁（RVsw, LVsw）的基部（1-8段）、中室（9-16段）和顶点（17-24段）的平均位移长度。采用分数多项式回归分析，以胎龄为自变量，计算左室、左室自由壁和间隔壁基部、中室和顶点位移长度的平均方程。采用Kruskal-Wallis检验和Bonferroni校正来比较RVfw与RVsw、LVfw与LVsw、RVfw与LVfw、RVsw与LVsw之间的基部、中腔和顶点段的平均值。此外，超声程序提供了左室和左室自由壁和间隔壁收缩段长度的图像。四个心脏病理例子说明异常游离和间隔壁段移位。结果：RVfw（基底和中腔）和LVfw（基底、中腔和心尖）的收缩末位移长度随胎龄增加而增加。然而，随着胎龄的增加，RVsw和LVsw节段长度没有增加或增加很少。游离壁的位移长度比基底、中腔和心尖的间隔壁要大。当RV与LV比较时，RVfw的节段长度明显大于底部的LVfw。LVsw的节段长度明显大于RVsw的基部、中腔和尖端。中腔和心尖的左室节段向内移动。对于左心室，收缩期左心室和左心室之间的节段长度移动。4例病理表现为RVfw、LVfw、RVsw和LVsw的异常运动。结论：斑点跟踪分析可以定量测量收缩期心室游离壁和间隔壁段位移，并可以图形显示位移，当心功能异常时可用于识别病理变化。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Ultrasound in Medicine 医学-核医学

CiteScore

5.10

自引率

4.30%

发文量

205

审稿时长

1.5 months

期刊介绍： The Journal of Ultrasound in Medicine (JUM) is dedicated to the rapid, accurate publication of original articles dealing with all aspects of medical ultrasound, particularly its direct application to patient care but also relevant basic science, advances in instrumentation, and biological effects. The journal is an official publication of the American Institute of Ultrasound in Medicine and publishes articles in a variety of categories, including Original Research papers, Review Articles, Pictorial Essays, Technical Innovations, Case Series, Letters to the Editor, and more, from an international bevy of countries in a continual effort to showcase and promote advances in the ultrasound community. Represented through these efforts are a wide variety of disciplines of ultrasound, including, but not limited to: -Basic Science- Breast Ultrasound- Contrast-Enhanced Ultrasound- Dermatology- Echocardiography- Elastography- Emergency Medicine- Fetal Echocardiography- Gastrointestinal Ultrasound- General and Abdominal Ultrasound- Genitourinary Ultrasound- Gynecologic Ultrasound- Head and Neck Ultrasound- High Frequency Clinical and Preclinical Imaging- Interventional-Intraoperative Ultrasound- Musculoskeletal Ultrasound- Neurosonology- Obstetric Ultrasound- Ophthalmologic Ultrasound- Pediatric Ultrasound- Point-of-Care Ultrasound- Public Policy- Superficial Structures- Therapeutic Ultrasound- Ultrasound Education- Ultrasound in Global Health- Urologic Ultrasound- Vascular Ultrasound