Prospective Assessment of Fetal Cardiac Function With Speckle Tracking in Healthy Fetuses and Recipient Fetuses of Twin-to-Twin Transfusion Syndrome

Van Mieghem, Tim; Giusca, Sorin; DeKoninck, Philip; Gucciardo, Leonardo; Doné, Elisa; Hindryckx, An; D'Hooge, Jan; Deprest, Jan

doi:10.1016/j.echo.2009.12.024

« Previous Next »Journal of the American Society of Echocardiography
Volume 23, Issue 3 , Pages 301-308, March 2010

Prospective Assessment of Fetal Cardiac Function With Speckle Tracking in Healthy Fetuses and Recipient Fetuses of Twin-to-Twin Transfusion Syndrome

Tim Van Mieghem, MD
- Department of Woman and Child, Division Woman, Fetal Medicine Unit, University Hospitals Leuven, Leuven, Belgium
Sorin Giusca, MD
- Department of Cardiovascular Diseases, Division of Cardiovascular Imaging and Dynamics, University Hospitals Leuven, Leuven, Belgium
Philip DeKoninck, MD
- Department of Woman and Child, Division Woman, Fetal Medicine Unit, University Hospitals Leuven, Leuven, Belgium
Leonardo Gucciardo, MD
- Department of Woman and Child, Division Woman, Fetal Medicine Unit, University Hospitals Leuven, Leuven, Belgium
Elisa Doné, MD
- Department of Woman and Child, Division Woman, Fetal Medicine Unit, University Hospitals Leuven, Leuven, Belgium
An Hindryckx, MD
- Department of Woman and Child, Division Woman, Fetal Medicine Unit, University Hospitals Leuven, Leuven, Belgium
Jan D'Hooge, PhD
- Department of Cardiovascular Diseases, Division of Cardiovascular Imaging and Dynamics, University Hospitals Leuven, Leuven, Belgium
Jan Deprest, MD, PhD
- Department of Woman and Child, Division Woman, Fetal Medicine Unit, University Hospitals Leuven, Leuven, Belgium
- Reprint requests: Jan Deprest, MD, PhD, University Hospitals Leuven, Department of Obstetrics and Gynecology, Herestraat 49, B-3000 Leuven, Belgium.

published online 08 February 2010.

Background

The aim of this study was to assess speckle tracking–derived fetal cardiac function in a normal population and in recipient fetuses of twin-to-twin transfusion syndrome (TTTS).

Methods

A case-control study was conducted of 59 uncomplicated singleton pregnancies and 17 recipient fetuses of TTTS. Peak systolic strain, strain rate, velocity, and displacement were calculated, corrected for gestational age, and compared between patients with TTTS and controls.

Results

The feasibility of speckle tracking was 83% in controls but only 61% in patients with TTTS. Myocardial velocity and displacement increased over gestation, and regional differences were present within each wall and between walls. Strain and strain rate were stable within each wall but were higher in the right ventricle than in the left ventricle and septum. Right ventricular strain was decreased in patients with TTTS compared with controls (0.75 ± 0.34 vs 1.00 ± 0.37 multiples of the median, P = .04).

Conclusion

The feasibility of speckle tracking is low when imaging conditions are challenging, but it can identify right ventricular failure in selected patients with TTTS.

Keywords: Fetal cardiac function, Echocardiography, Strain, Strain rate, Speckle tracking, Twin-to-twin transfusion syndrome