Cardiac function evaluated by two-dimensional speckle tracking imaging in fetuses with congenital heart disease of ventricular afterload increase

Figures & data

Figure 1. The tissue Doppler curve showed the calculation of the MPI index. MPI: myocardial performance index; ICT: isovolumetric contraction time; IRT: isovolumic relaxation time; ET: ejection time; LV: left ventricle; LA: left atria; RV, right ventricle; RA, right atria; DAO: descending aorta.

Figure 2. The right ventricular global longitudinal strain curve. LS: longitudinal strain; LV: left ventricle; LA: left atria; RV: right ventricle; RA: right atria; DAO, descending aorta.

Figure 3. The right ventricular global longitudinal strain rate curve. SRs: systolic wave; SRe: early diastolic wave; SRa: late diastolic wave; LV: left ventricle; LA: left atria; RV: right ventricle; RA: right atria; DAO: descending aorta.

Table 1. Diagnosis of congenital heart disease with left or right outflow obstruction.

Group	Diagnosis	Number
Group LVA	Aortic arch coarctation associated with ventricular septal defect	4
	Aortic arch coarctation associated with aortic dysplasia and ventricular septal defect	2
	Aortic arch coarctation	6
	Interrupted aortic arch associated with ventricular septal defect	2
	Aortic dysplasia	9
	Aortic stenosis	2
Group RVA	Dysplasia of pulmonary artery	2
	Pulmonary stenosis and right ventricular double outlet	8
	Pulmonary valve atresia	8
	Pulmonary stenosis	5

Table 2. The comparison of parameters between LVA and control group.

	Control Group (n = 41)	Group LVA (n = 25)	p value
Frame Frequency	186 ± 47	156 ± 42	.06
Heart Rate (bpm)	148 ± 7	148 ± 10	.96
Left Ventricle Systolic Function
FS (%)	36.26 (33.41,40.10)	36.00 (32.00,38.10)	.20
LS (%)	−27.53 (−24.33,−29.16)	−15.97 (−12.50,−22.52)	<.01*
SRs (1/sec)	−2.55 (−2.28,-2.92)	−1.34 (−1.12,−2.16)	<.01*
Left Ventricle Diastolic Function
MV e‘/a’	0.60 ± 0.10	0.58 ± 0.09	.58
MV E/e’	8.98 ± 2.30	11.43 ± 4.65	.02*
SRe (1/sec)	2.46 ± 0.61	1.70 ± 0.57	<.01*
SRa (1/sec)	2.39 ± 0.81	1.62 ± 0.82	<.01*
MPI	0.42 ± 0.04	0.56 ± 0.11	<.01*
Right Ventricle Systolic Function
FS (%)	35.45 (33.33,38.94)	36.11 (33.33,39.00)	.79
LS (%)	−26.38 ± 3.97	−25.32 ± 6.49	.52
SRs (1/sec)	−2.37 ± 0.44	−2.18 ± 0.42	.21
Right Ventricle Diastolic Function
TV e‘/a’	0.57 ± 0.08	0.50 ± 0.10	<.01*
TV E/e’	6.85 ± 1.38	7.35 ± 1.76	.38
SRe (1/sec)	2.11 ± 0.85	2.13 ± 0.86	.93
SRa (1/sec)	2.90 ± 0.77	2.47 ± 0.38	.08
MPI	0.42 ± 0.06	0.52 ± 0.07	<.01*

*p < .05.

Table 3. The comparison of parameters between RVA and control group.

	Control Group(n = 41)	Group RVA(n = 23)	p value
Frame Frequency	186 ± 47	167 ± 42	.05
Heart Rate (bpm)	148 ± 7	145 ± 10	.58
Left Ventricle Systolic Function
FS (%)	36.26 (33.41, 40.10)	34.21 (32.00.38.50)	.09
LS (%)	−26.79 ± 3.22	−21.52 ± 6.68	<.01*
SRs(1/sec)	−2.56 ± 0.43	−2.11 ± 0.78	.02*
Left Ventricle Diastolic Function
MV e‘/a’	0.60 ± 0.10	0.61 ± 0.10	.83
MV E/e’	8.98 ± 2.30	10.48 ± 1.34	.11
SRe(1/sec)	2.52 (1.95,2.99)	2.06 (1.85,2.39)	.01
SRa(1/sec)	2.39 ± 0.81	1.91 ± 0.79	.04*
MPI	0.42 ± 0.04	0.52 ± 0.07	<.01*
Right Ventricle Systolic Function
FS (%)	35.45 (33.33,38.94)	35.00 (27.11, 37.50)	.06
LS (%)	−26.38 ± 3.97	−17.64 ± 7.58	<.01*
SRs (1/sec)	−2.37 ± 0.44	−1.62 ± 0.67	<.01*
Right Ventricle Diastolic Function
TV e‘/a’	0.57 ± 0.08	0.58 ± 0.11	.82
TV E/e’	6.85 ± 1.38	7.29 ± 3.31	.72
SRe(1/sec)	2.11 ± 0.85	1.56 ± 0.74	.02*
SRa(1/sec)	2.90 ± 0.77	1.76 ± 0.84	<.01*
MPI	0.42 ± 0.06	0.60 ± 0.07	<.01*

*p < .05.

Table 4. Inter-observer and intra-observer variability.

Charact-eristics	Intra-class correlation coefficient (95%CI)	p value	Inter-class correlation coefficient (95%CI)	p value
LV-LS	0.98 (0.95–0.98)	<.001	0.7 (0.52–0.82)	<.001
LV-SRs	0.96 (0.89–0.95)	<.001	0.65 (0.43–0.78)	<.001
LV-SRe	0.89 (0.83–0.93)	<.001	0.65 (0.43–0.78)	<.001
LV-SRa	0.94 (0.90–0.96)	<.001	0.68 (0.48–0.80)	<.001
RV-LS	0.97 (0.96–0.98)	<.001	0.69 (0.50–0.81)	<.001
RV-SRs	0.89 (0.83–0.93)	<.001	0.61 (0.42–0.80)	<.001
RV-SRa	0.93 (0.89–0.95)	<.001	0.61 (0.42–0.80)	<.001
RV-SRe	0.91 (0.86–0.94)	<.001	0.64 (0.43–0.78)	<.001