Speckle tracking echocardiography in fetuses diagnosed with congenital diaphragmatic hernia. (22nd August 2014)

• Record Type: Journal Article
• Authors: DeKoninck, Philip; D'hooge, Jan; Van Mieghem, Tim; Richter, Jute; Deprest, Jan
• Is Part Of: Prenatal diagnosis. Volume 34:Number 13(2014:Dec.)
• Page Start: 1262
• Page End: 1267
• Publication Date: 2014-08-22
• Subjects: Prenatal diagnosis -- Periodicals; Fetus -- Diseases -- Diagnosis -- Periodicals; Electronic journals; 618.32075
• DOI: 10.1002/pd.4461
• Languages: English
• ISSNs: 0197-3851

Abstract

<abstract abstract-type="main"> <title>ABSTRACT</title> <sec id="pd4461-sec-0001" sec-type="section"> <title>Objective</title> <p>The aim of this study is to evaluate cardiac function in fetuses with congenital diaphragmatic hernia (CDH) using speckle tracking.</p> </sec> <sec id="pd4461-sec-0002" sec-type="section"> <title>Method</title> <p>Case‐control study assessed cardiac contractility in consecutive fetuses with CDH. Controls were anatomically normal fetuses, adjusted for gestational age. Speckle tracking software calculated ventricular peak longitudinal velocity, displacement and strain. Pulmonary hypoplasia was assessed using observed/expected lung‐to‐head ratio (O/E LHR).</p> </sec> <sec id="pd4461-sec-0003" sec-type="section"> <title>Results</title> <p>Thirty‐eight fetuses with CDH (29 left and nine right) were evaluated at a mean gestational age of 26.9 ± 2.5 weeks. In six fetuses, the acquired images were of insufficient quality (feasibility 83%). Velocity and displacement showed regional differences, as well as significant differences between the ventricular walls, similar to control fetuses. Strain measurements also demonstrated regional differences yet less uniformly arranged. In left CDH, we observed increased strain values in the left ventricle compared with controls (−18.7 ± 7.2 vs −15.1 ± 4.9). There was no correlation between strain values in the left ventricle and O/E LHR. In fetuses with right CDH, deformation analysis was not different from controls.</p> </sec> <sec id="pd4461-sec-0004" sec-type="section"> <title>Conclusions</title> <p>In fetuses with CDH, no cardiac dysfunction could be detected despite the often concurrent hypoplasia of ipsilateral cardiac structures. In fetuses with left CDH, the decrease in ventricular size coincides with increased strain values in the free left ventricular wall. © 2014 John Wiley & Sons, Ltd.</p> </sec> </abstract>