Novel Speckle Tracking Analysis Showed Excellent Reproducibility for Size and Shape of the Fetal Heart and Good Reproducibility for Strain and Fractional Shortening

2021 ◽  
Vol 48 (7) ◽  
pp. 541-550
Author(s):  
Erin S. Huntley ◽  
Edgar Hernandez-Andrade ◽  
Eleazar Soto ◽  
Gregory DeVore ◽  
Baha M. Sibai
Keyword(s):  
Speckle Tracking ◽  
Cardiac Cycle ◽  
Fetal Heart ◽  
Moderate Correlation ◽  
Anatomical Structures ◽  
Global Strain ◽  
Moderator Band ◽  
Sphericity Index ◽  
Fractional Shortening ◽  
Excellent Reproducibility

<b><i>Introduction:</i></b> This study aimed to evaluate reproducibility and agreement of fetal cardiac shape and deformation using <i>FetalHQ</i>. <b><i>Methods:</i></b> Fifty normal fetuses at 20–38 weeks of gestation were evaluated. Two operators independently selected an optimal cardiac cycle using <i>FetalHQ</i><sup>®™</sup>software for speckle tracking analysis. Intra- and interobserver correlation coefficient and limits of agreement for cardiac shape and deformation were estimated. <b><i>Results:</i></b> Global cardiac markers: high correlation (<i>r</i> = 0.98) and agreement (mean difference, standard deviation [MD, SD] 5.07, 75.8) for ventricular area; moderate correlation (<i>r</i> = 0.78) and agreement (MD, SD: 0.016, 0.08) for global sphericity index (SI) and for left ventricle (LV) global strain (<i>r</i> = 0.65; MD, SD: −4.48, 11.9); and low but still significant correlation (<i>r</i> = 0.58) and agreement (MD, SD: −3.77, 12.27) for right ventricle (RV) global strain. For individual ventricular parameters: high correlation for LV ([median <i>r</i>; range] 0.98; 0.93–0.99) and RV (<i>r</i> = 0.98; 0.97–1.0) SI, and for LV (<i>r</i> = 0.92: 0.56–0.99) and RV (<i>r</i> = 0.96; 0.67–0.99) end diastolic diameters; moderate correlation for LV fractional shortening (<i>r</i> = 0.53; 0.87–0.98); and no significant correlation for RV fractional shortening (<i>r</i> = 0.36; 0.32–0.97). Inter- and intraobserver correlation and agreement were similar for all evaluated parameters. <b><i>Conclusion:</i></b> Speckle tracking analysis of the fetal heart provides reliable estimations of global and LV shape and deformation. Low correlation in the RV can be related to anatomical structures such as the moderator band.

A 24-segment fractional shortening of the fetal heart using FetalHQ

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Toshiyuki Hata ◽  
Aya Koyanagi ◽  
Tomomi Yamanishi ◽  
Saori Bouno ◽  
Riko Takayoshi ◽  
...  
Keyword(s):  
Left Ventricle ◽  
Right Ventricle ◽  
Right Ventricular ◽  
Speckle Tracking ◽  
Fetal Heart ◽  
Correlation Coefficients ◽  
Left Ventricular ◽  
Basal Segment ◽  
The Right ◽  
Fractional Shortening

AbstractObjectivesTo evaluate 24-segment fractional shortening (FS) of the fetal heart using FetalHQ by speckle-tracking regarding reproducibility and the change with advancing gestation.MethodsEighty-one pregnant women at 18–21 + 6 and 28–31 + 6 weeks of gestation were studied using FetalHQ with the speckle-tracking technique to calculate 24-segment FS of left and right ventricles. Intra- and inter-class correlation coefficients and intra- and inter-observer agreements of measurements for FS were assessed in each segment.ResultsWith respect to intra-observer reproducibility, all FS values showed correlations between 0.575 and 0.862 for the left ventricle, with good intra-observer agreements except for left ventricular segments 14–24. Right ventricular FS values showed correlations between 0.334 and 0.685, with good intra-observer agreements. With respect to inter-observer reproducibility, all FS values showed correlations between 0.491 and 0.801 for the left ventricle, with good intra-observer agreements except for left ventricular segments 16–22. Right ventricular FS values showed correlations between 0.375 and 0.575, with good inter-observer agreements. There were significant differences in the mean FS values in the basal segment (segments 1–5) of the left ventricle between 18 and 21 + 6 and 28–31 + 6 weeks of gestation (p<0.05), whereas there were significant differences in all mean FS values in the right ventricle between both gestational ages (p<0.05).ConclusionsThese results suggest that the reproducibility of the 24-segment FS of the fetal heart using FetalHQ is fair. However, there may be significant differences in FS values with advancing gestational age, especially for the right ventricle.

Evaluation of the sphericity index of the fetal heart during middle and late pregnancy using fetalHQ

2021 ◽  
pp. 1-6
Author(s):  
Yingchun Luo ◽  
Fang Xiao ◽  
Can Long ◽  
Haiyan Kuang ◽  
Meiping Jiang ◽  
...  
Keyword(s):  
Fetal Heart ◽  
Late Pregnancy ◽  
Sphericity Index

scholarly journals Evaluation of prenatal changes in fetal cardiac morphology and function in maternal diabetes mellitus using a novel fetal speckle-tracking analysis: a prospective cohort study

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Dong Wang ◽  
Caixia Liu ◽  
Xinyu Liu ◽  
Ying Zhang ◽  
Yu Wang
Keyword(s):  
Diabetes Mellitus ◽  
Cohort Study ◽  
Pregnant Women ◽  
Gestational Age ◽  
Speckle Tracking ◽  
Control Group ◽  
Second Trimester ◽  
Cardiac Morphology ◽  
Sphericity Index ◽  
And Function

Abstract Background Due to metabolic changes in the second trimester and the increasing number of pregnant women with obesity and advanced maternal age, the incidence of gestational diabetes mellitus (GDM) remains high. This study aimed to evaluate the effects of GDM on fetal cardiac morphology and function, and to determine whether these changes increase with increasing estimated fetal weight (EFW). Methods Fifty-eight women with GDM (GDM group) and 58 women with a healthy pregnancy (control group) were included in this prospective observational cohort study. Each group included subgroups of 31 pregnant women with a gestational age between 24+0 weeks and 27+6 weeks as well as 27 pregnant women with a gestational age between 28+0 weeks and 40+0 weeks. For all fetuses, a cine of 2–3 s in the four-chamber view was obtained, and online speckle-tracking analysis was performed using the GE Automatic Fetal Heart Assessment Tool (fetal HQ; General Electric Healthcare Ultrasound, Zipf, Austria) to measure the global sphericity index (GSI), global longitudinal strain (GLS), fractional area change (FAC), 24-segment sphericity index (SI), and 24-segment end-diastolic diameter of the left ventricle (LV) and right ventricle (RV). Data were analyzed using the independent t-test and Wilcoxon rank-sum test, as applicable. Results The GDM group (mean HbA1c value was 5.3 ± 0.57 mmol/L) showed a lower GSI value than the control group (1.21 vs. 1.27, P = 0.000), which indicated a rounder shape of the heart. In addition, fetuses in the GDM group demonstrated significant impairment in cardiac function compared to those in the control group (LV-GLS: -18.26% vs. -22.70%, RV-GLS: -18.52% vs. -22.74%, LV-FAC: 35.30% vs. 42.36%, RV-FAC: 30.89% vs. 36.80%; P = 0.000 for all). Subgroup analyses according to gestational age (24+0–27+6 weeks and 28+0–40+0 weeks) showed that the statistical differences were retained between the GDM and control groups in each subgroup. Conclusions Fetuses of women with GDM present with signs of biventricular systolic dysfunction according to deformation analysis using fetal HQ. Additionally, the heart had a rounder shape in the GDM group than in the control group. This study showed that fetal HQ can be used to assess fetal cardiac morphology and function easily and quickly, and the effects of GDM on fetal cardiac morphology and function appeared from the second trimester. Thus, whether earlier and stricter clinical intervention was necessary remained to be further studied. Furthermore, future studies will need to supplement the effects of blood glucose levels on GLS, FAC, GSI, and 24-segment SI. Additionally, the long-term follow-up after birth should also be improved to observe the influence of changes in the indicators on the prognosis.

scholarly journals Assessment of aortic and mitral annuli dynamics during the cardiac cycle using speckle tracking echocardiography

2014 ◽  
Vol 1 (1) ◽  
pp. 11-16 ◽  
Author(s):  
Wenjuan Bai ◽  
Hui Li ◽  
Hong Tang ◽  
Qing Zhang ◽  
Ye Zhu ◽  
...  
Keyword(s):  
Left Ventricular Function ◽  
Ventricular Function ◽  
Speckle Tracking ◽  
Cardiac Cycle ◽  
Speckle Tracking Echocardiography ◽  
Left Ventricular ◽  
Healthy Adults ◽  
Aortic Annulus ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction

The aims of this study were i) to evaluate mitral and aortic annuli excursion, and aortomitral angle (AMA) during the cardiac cycle in healthy adults using two-dimensional speckle tracking echocardiography, ii) to assess two annuli dynamics and coupling behaviors as an integral, and iii) to detect the relation between two annuli and left ventricular ejection fraction (LVEF). A total of 74 healthy adults underwent transthoracic echocardiography. In the parasternal long-axis view, a number of points were extracted, including right coronary aortic annular, aortomitral fibrous junction, and posterior mitral annular points. The annuli excursion and AMA were measured using a speckle tracking-derived software during the cardiac cycle. During the isovolumic contraction and the isovolumic relaxation phase, annuli excursion and AMA remain stable for a short time. During the systole, annuli excursion increased sharply to the maximum, while AMA narrowed quickly to the minimum value. During the diastole, there are three patterns of decrease in annuli excursion and AMA expansion in different phases. The annuli excursion of three points correlates well with the LVEF (right coronary aortic annulus excursion, r=0.71, P<0.05; non-coronary aortic annulus excursion, r=0.70, P<0.05; posterior mitral annulus excursion, r=0.82, P<0.05). Moreover, there are positive correlations between annuli excursion and the variation of AMA (r=0.60, P<0.05). The annuli excursion and AMA have various regular patterns in healthy adults. The interactions of mitral and aortic annuli correlate with the left ventricular function. Our findings may have relevance to the evaluation of left ventricular function and presurgical planning of patients with valvular diseases.

scholarly journals Role of LA strain assessed by speckle tracking echocardiography in predicting patients who develop POAF after a coronary artery bypass surgery

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
V Rukmani Prabha ◽  
N Rajeshwari ◽  
J Jenifer
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Left Atrial ◽  
Speckle Tracking ◽  
Speckle Tracking Echocardiography ◽  
Artery Bypass ◽  
Coronary Risk Factors ◽  
Global Strain ◽  
The Mean

Abstract Objectives To evaluate the correlation between left atrial dysfunction assessed by speckle tracking echocardiography and development of postoperative atrial fibrillation (POAF) in patients undergoing coronary artery bypass grafting. To determine the role of coronary risk factors in development of POAF. Method Patients undergoing CABG from January 2019 till June 2020 in Apollo institute, fulfilling the inclusion and exclusion criteria were included.Total of 200 patients were followed.They were subjected to LA strain and strain rate analysis by speckle tracking. Results The incidence of POAF in our study was 24% (n=48). The mean age of this study population was 59.13 years. The patients who developed POAF were older (68.5±9.048 vs 58.39±9.74 years, p value=0.05) than those with no POAF. POAF occurred in 2 phases. the highest proportion of POAF occurrence noticed on postoperative day 2. Among the total POAF cases 79.% occurred within the first 48 hours and 20.8% occurred later (p=0.001). Among the 48 patients who developed POAF, 5 of them developed recurrence during their hospital stay. They had reverted to sinus rhythm following anti-arrhythmic medication for a duration of &gt;24 hours, but went on to develop recurrence of AF at a later. 4 among them reverted to sinus rhythm at discharge while 1 continued to remain in AF at discharge.The duration of hospital stay for patients with POAF group was 10.4 days compared with 10.04 days for those without POAF. Similarly the post-operative stay in the hospital was 7.4 days for the POAF group and 7.04 days for the NO POAF.There was no added economic impact secondary to AF.Comparing the values of left atrial volume index of both the groups it was derived that the mean LAVI value of the POAF group was 26.84+3.654 ml/m2 and that for the NO POAF group was 26.6+3.037ml/m2. Though the patients with POAF had larger LA volume, the chi square test analysis did not yield any clinically significant relationship between LAVI and POAF in our study (p=0.3). The mean LA global strain for the patients with POAF was 29.73+3.695%. And for the patients with no POAF was 36.3+4.854%. LA global strain was reduced in patients who developed POAF (P&lt;0.001) which indicated a strong correlation between LA strain and POAF. Conclusion There is significant correlation between Global Left Atrial Strain and POAF in patients undergoing CABG (P&lt;0.001).There is no significant correlation between patient factors like age, BMI, and the conventional coronary risk factors with POAFThere is no significant correlation between the conventional echocardiographic parameters like LA diameter, LAVI, LVDD, LVSD, LVEF and transmitral flow velocities with POAF. To conclude, preoperative speckle tracking assessment of LA has a strong predictive role in determining the occurrence of POAF in patients undergoing Coronary artery bypass grafting surgery. FUNDunding Acknowledgement Type of funding sources: None.

Master Frame Extraction of Fetal Cardiac Images Using B Mode Ultrasound Images

2022 ◽  
Vol 54 ◽  
pp. 51-64
Author(s):  
Sushma Tumkur Venugopal ◽  
Sriraam Natarajan ◽  
Megha P. Arakeri ◽  
Suresh Seshadri
Keyword(s):  
Mean Square Error ◽  
Hausdorff Distance ◽  
Cardiac Cycle ◽  
Fetal Heart ◽  
Fetal Echocardiography ◽  
Similarity Index ◽  
Structural Similarity ◽  
Ultrasound Images ◽  
Mean Square ◽  
Structural Similarity Index

Fetal Echocardiography is used for monitoring the fetal heart and for detection of Congenital Heart Disease (CHD). It is well known that fetal cardiac four chamber view has been widely used for preliminary examination for the detection of CHD. The end diastole frame is generally used for the analysis of the fetal cardiac chambers which is manually picked by the clinician during examination/screening. This method is subjected to intra and inter observer errors and also time consuming. The proposed study aims to automate this process by determining the frame, referred to as the Master frame from the cine loop sequences that can be used for the analysis of the fetal heart chambers instead of the clinically chosen diastole frame. The proposed framework determines the correlation between the reference (first) frame with the successive frames to identify one cardiac cycle. Then the Master frame is formed by superimposing all the frames belonging to one cardiac cycle. The master frame is then compared with the clinically chosen diastole frame in terms of fidelity metrics such as Dice coefficient, Hausdorff distance, mean square error and structural similarity index. The average value of the fidelity metrics considering the dataset used for this study 0.73 for Dice, 13.94 for Hausdorff distance, 0.99 for Structural Similarity Index and 0.035 for mean square error confirms the suitability of the proposed master frame extraction thereby avoiding manual intervention by the clinician. .

Assessment of the Size and Shape of the 4-Chamber View and the Right and Left Ventricles using Fetal Speckle Tracking in Normal Fetuses at 17-24 Gestational Weeks

2021 ◽  
Author(s):  
Sanitra Anuwutnavin ◽  
Kusol Russameecharoen ◽  
Pornpimol Ruangvutilert ◽  
Sommai Viboonchard ◽  
Mark Sklansky ◽  
...  
Keyword(s):  
Speckle Tracking ◽  
Fetal Heart ◽  
Reference Intervals ◽  
Reference Ranges ◽  
Z Score ◽  
Size And Shape ◽  
Chamber View ◽  
Normal Reference ◽  
Length Width ◽  
The Right

Introduction: The aim of the study was to establish normal reference values obtained by fetal speckle tracking analysis of the fetal heart between 17-24 weeks of gestation among Thai fetuses and compare the nomograms with previous studies. Methods: The 4-chamber view of the fetal heart in 79 normal fetuses was analyzed by speckle tracking analysis to determine the best-fit regression model. The 95% reference intervals and Z-score equations of fetal cardiac parameters were computed. Results: The end-diastolic length, width, area, and circumference of the 4-chamber view (4CV) as well as the ventricular end-diastolic length, 24-segment widths, and area were all increased as a function of gestational age (GA) and 5 fetal biometric parameters. In contrast, the global sphericity index (SI), 24-segment SI, and right ventricle/left ventricle width and area ratios did not change with GA or fetal biometric measurements. There were few differences in Z-score reference ranges of fetal cardiac measurements between the current study and previous studies conducted in different patient populations. Conclusion: Our study provided z-score and corresponding centile calculators, 5th and 95th centile reference tables, and corresponding graphs for evaluating the size and shape of the 4CV and the right and left ventricles using 6 independent variables between 17 and 24 weeks of gestation. These results provide normal reference ranges for future studies of fetuses with pathologies that may alter the size and shape of the 4-chamber view and ventricles.

Abstract 12381: Advantage of Aortic Valve Reconstruction in Dynamic Changes of Aortic Annulus Assessed by Speckle Tracking Echocardiography After Aortic Valve Surgery

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Go Hashimoto ◽  
Makoto Suzuki ◽  
Hisao Yoshikawa ◽  
Takenori Otsuka ◽  
Yukiko Isekame ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Speckle Tracking ◽  
Cardiac Cycle ◽  
Aortic Annulus ◽  
Control Group ◽  
Dynamic Changes ◽  
Significant Difference ◽  
Valve Reconstruction ◽  
Cyclic Changes ◽  
Annulus Diameter

Introduction: It is reported that aortic valve reconstruction (AVrC) by using autologous pericardium is useful in patients with various aortic valve diseases. This method may be more effective in preserving the natural motion of the aortic valve annulus. Significant dynamic changes in the aortic annulus have previously been reported in animal models and clinical studies. The purpose of this study is to analize the cyclic changes of the aortic annulus using speckle-tracking trans-esophageal echocardiography in patients who underwent AVrC surgery. Methods: The subjects were 35 patients underwent AVrC surgery for aortic regurgitation or aortic stenosis and 40 controls. Cyclic aortic annulus diameter of the maximum and minimum diameters were determined from a speckle-tracking displacement curve (figure). These data was used to calculate the absolute change in the diameter of the aortic annulus, which was defined as the difference in diameters throughout the cardiac cycle. Results: There was significant difference between maximum and minimum aortic annulus diameter in AVrC group (18.7±3.0 mm vs 16.1±2.9 mm, p<0.0001). There was significant difference in the maximum and minimum aortic annulus diameter in control group (22.9±2.7 mm vs 20.0±2.9 mm, p<0.0001). AVrC group had significant cyclic change of aortic annulus as same as control group (AVrC group : 2.6±1.0 mm vs control group : 2.9±0.7 mm, p= NS). Conclusions: Our study suggests that dynamic changes of the aortic annulus occur in the cardiac cycle and can be measured using speckle-tracking trans-esophageal echocardiography. AVrC may preserve the coordination of the left ventricle, aortic annulus, sinus of Valsalva and aorta compared with conventional aortic valve replacement.

Quantitative measurements of celeration times and indexes in the ductus venosus spectral Doppler waveforms in normal fetuses

2020 ◽  
Vol 48 (3) ◽  
pp. 274-279
Author(s):  
Cemil Gürses ◽  
Burak Karadağ ◽  
Onur Erol
Keyword(s):  
Fetal Heart Rate ◽  
Cardiac Cycle ◽  
Fetal Heart ◽  
Ductus Venosus ◽  
Quantitative Measurements ◽  
Atrial Contraction ◽  
Spectral Doppler ◽  
Positive Correlations ◽  
Main Components ◽  
Two Peaks

AbstractBackgroundDuctus venosus spectral waveform has two peaks and two nadirs: S, v, D and a velocities, which are obtained after to some extent of accelerations or decelerations throughout a cardiac cycle. It is aimed to define the actual celeration times and indexes and their relationships with the fetal heart rate (FHR).MethodsThe acceleration times and indexes were measured in 357 patients between 11 and 40 weeks of pregnancies with low risk.ResultsThe FHR has a gradual increasing negative correlation from time for S to time for a with each of the cardiac times of phases according to the statistical analysis (correlations were minus 190, 269, 407 and 541 for S, v, D and a phase times, respectively). The acceleration aS and the deceleration Da have positive correlations with the FHR; however, the deceleration Sv and the acceleration vD do not correlate with the FHR.ConclusionThe deceleration Da time and index are the main components for determining the FHR in fetuses. Therefore, the atrial contraction is the strongest component for determining the FHR in fetuses.

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