Fetal Left Ventricle Function Evaluated by Two-Dimensional Speckle-Tracking Echocardiography across Clinical Stages of Severity in Growth-Restricted Fetuses

Fetal growth restriction (FGR) can result in adverse perinatal outcomes due to cardiac dysfunction. This study used 2D speckle-tracking echocardiography to assess left ventricle (LV) longitudinal strain across FGR severity stages. A prospective longitudinal cohort study measured global (GLS) and seg...

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Bibliographic Details
Published in:Diagnostics (Basel) 2024-03, Vol.14 (5), p.548
Main Authors: Domínguez-Gallardo, Carla, Ginjaume-García, Nuria, Ullmo, Johana, Parra, Juan, Vázquez, Ana, Cruz-Lemini, Mónica, Llurba, Elisa
Format: Article
Language:English
Subjects:
2D speckle tracking
Birth weight
Cardiac function
Echocardiography
fetal cardiac function
fetal echocardiography
fetal growth restriction
Fetus
Fetuses
Gestational age
Growth
Heart
Hospitals
Pregnancy
prenatal diagnosis
Software
Standard scores
Statistical analysis
strain
Ultrasonic imaging
Variance analysis
Veins & arteries
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Summary:Fetal growth restriction (FGR) can result in adverse perinatal outcomes due to cardiac dysfunction. This study used 2D speckle-tracking echocardiography to assess left ventricle (LV) longitudinal strain across FGR severity stages. A prospective longitudinal cohort study measured global (GLS) and segmental LV longitudinal strain in FGR fetuses, with evaluations conducted at various time points. FGR was classified into subtypes based on published criteria using fetal weight centile and Doppler parameters. A linear mixed model was employed to analyze repeated measures and compare Z-score measurements between groups throughout gestational age. The study included 40 FGR fetuses and a total of 107 evaluations were performed: 21 from small for gestational age (SGA), 74 from the FGR stage I, and 12 from the FGR stage ≥ II. The results indicate that SGA and stage I FGR fetuses exhibit higher LV GLS than stages ≥ II. Throughout gestation, SGA and FGR stage I fetuses showed similar behavior with consistently better LV GLS values when compared to FGR stages ≥ II. No significant differences were observed in LV GLS strain behavior between SGA and FGR stage I. In conclusion, all FGRs show signs of early cardiac dysfunction, with severe cases demonstrating significantly a lower LV GLS when compared to mild cases, suggesting deterioration of cardiac dysfunction with progression of fetal compromise.
ISSN:2075-4418
2075-4418
DOI:10.3390/diagnostics14050548