Assessment of Left Ventricular Global and Regional Longitudinal Peak Systolic Strain, Strain Rate and Velocity with Feature Tracking in Healthy Fetuses

Zusammenfassung

Ziel: Studienziel war es, den Zusammenhang von ultrasonografisch ermittelten Messungen des linksventrikulären Myokards basierend auf „Feature tracking“-Technik und dem Schwangerschaftsalter zu evaluieren. Material und Methoden: Globale und segmentale, longitudinale Strain-, Strain-rate- und Geschwindigkeitsmesswerte des linksventrikulären Myokards wurden mittels einer neuen „Feature tracking“-Technik für jedes Schwangerschaftsalter an 150 gesunden Feten (13. – 39. Schwangerschaftswoche) untersucht. Die Inter- und Intraobserver-Variabilität wurden zusätzlich analysiert. Ergebnisse: Die globale longitudinale maximale systolische Geschwindigkeit wies einen segmentalen Basis-Apex-Gradienten auf (p < 0,001). Von der 13. – 39. Schwangerschaftswoche nahmen die globalen und segmentalen longitudinalen maximalen systolischen Geschwindigkeiten signifikant zu (p < 0,001), die globalen longitudinalen maximalen systolischen Strain-Werte blieben konstant (p = 0,34) und die entsprechenden Strain-rate-Werte wiesen lediglich einen abnehmenden Trend auf (p = 0,045). Die Inter- und Intraobserver-Variabilität für die globalen linksventrikulären maximalen Strain, Strain rate und Geschwindigkeitsmessungen waren akzeptabel. Die Standardabweichungen der Messfehler zwischen den beiden Untersuchern betrugen 2,5 %, 0,7 sec^–1 und 0,5 cm/sec. Schlussfolgerung: Die globalen myokardialen maximalen Geschwindigkeiten des linken Ventrikels nehmen mit zunehmendem Schwangerschaftsalter signifikant zu, während die entsprechenden Strain- und Strain-rate-Messwerte annährend konstant bleiben. Diese neue winkelunabhängige nicht invasive Technik eröffnet einen neuen objektiven Ansatz, die globale und segmentale myokardiale Performance zu quantifizieren.

Abstract

Purpose: The aim of this study was to evaluate the correlation of feature-tracking-derived measurements of the left ventricular myocardium in healthy fetuses with gestational age. Materials and Methods: The global and segmental longitudinal peak systolic strain, strain rate and velocity values of the left ventricular myocardium for each gestational age were assessed by a novel feature tracking technique in 150 healthy fetuses (gestational age range 13 – 39 weeks of gestation). The interobserver and intraobserver variability was analyzed. Results: The global longitudinal peak systolic velocity exhibited a segmental base to apex gradient (p < 0.001). From 13 to 39 weeks of gestation, the global and segmental longitudinal peak systolic velocities increased significantly throughout gestation (p < 0.001), while the global longitudinal peak systolic strain remained constant (p = 0.34) and the strain rate exhibited only a tendency to decrease (p = 0.045). The interobserver and intraobserver variability of the global LV peak systolic strain, strain rate and velocity was acceptable. The standard deviations of measurement error between the two observers were 2.5 %, 0.7 s^–1 and 0.5 cm/sec, respectively. Conclusion: The global myocardial peak systolic velocities of the left ventricle increase with gestational age, while the global myocardial peak systolic strain and strain rate remained nearly constant throughout gestation. This novel angle-independent, noninvasive technique offers a new objective approach to quantify global and segmental fetal myocardial performance throughout gestation.

Key words

cardiac - heart - echocardiography - ultrasound 2D

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