Fetal regional myocardial strain rate in the membranous ventricular septum: changes with gestational age and the left ventricular mass and predictive value for a complete membranous ventricular septum (without defect)
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To describe the fetal regional myocardial strain rate in the membranous ventricular septum across gestation and to determine their predictive value for a complete membranous ventricular septum (without defect) after delivery. In 1150 fetuses, the peak systolic strain rate (SRs), peak early diastolic strain rate (SRe) and peak late diastolic strain rate (SRa) in the membranous ventricular septum were measured at four time points across gestation (18–20, 24–26, 30–32 and 36–38 weeks). The integrity of the interventricular septum was examined at 12 weeks’ postnatal age. The correlations between myocardial strain rates and gestational age as well as fetal left ventricular mass were analyzed, and the performance of myocardial strain rates in predicting a complete membranous ventricular septum was deducted. Strain rate absolute values in the membranous ventricular septum all increased across gestation. They all significantly correlated with gestational age and left ventricular mass. At 24 weeks during pregnancy, the areas under the receiver operating characteristics curve (AUC) for SRe and SRa were all > 0.72 (p < 0.05) in predicting a complete membranous ventricular septum, while the AUC for SRs was only 0.55. The sensitivity, specificity and accuracy of the cut off value (> 1.53 s−1) for SRe was 62.5, 85.7 and 73.3%, respectively, and the sensitivity, specificity and accuracy of the cut off value (> 1.51 s−1) for SRa was 75.2, 71.9 and 73.8%, respectively. The changes of myocardial strain rates in the membranous ventricular septum across gestation maybe can be used to predict a complete membranous ventricular septum after delivery.
KeywordsPerimembranous ventricular septal defect Fetal echocardiography Strain rate Gestational age The left ventricular mass
The authors gratefully acknowledge the technical assistance of Xia EH, Huang XQ, Fan GX at the department of ultrasound, The First People’s Hospital of Yancheng, Jiangsu Province, P. R. China.
Compliance with ethical standards
Conflict of interest
The authors have no conflict of interest to declare.
- 4.Korinek J, Wang J, Sengupta PP, Miyazaki C, Kjaergaard J, McMahon E, Abraham TP, Belohlavek M (2005) Two-dimensional strain—a Doppler-independent ultrasound method for quantitation of regional deformation: validation in vitro and in vivo. J Am Soc Echocardiogr 18:1247–1253CrossRefPubMedGoogle Scholar
- 7.Crispi F, Sepulveda-Swatson E, Cruz-Lemini M, Rojas-Benavente J, Garcia-Posada R, Dominguez JM, Sitges M, Bijnens B, Grataco’s E (2012) Feasibility and reproducibility of a standard protocol for 2D speckle tracking and tissue Doppler-based strain and strain rate analysis of the fetal heart. Fetal Diagn Ther 32(1–2):96–108CrossRefPubMedGoogle Scholar
- 11.Lee J, Moghadam ME, Kung E, Cao H, Beebe T, Miller Y, Roman BL, Lien CL, Chi NC, Marsden AL, Hsiai TK (2013) Moving domain computational fluid dynamics to interface with an embryonic model of cardiac morphogenesis. PLoS ONE 8:e72924. https://doi.org/10.1371/journal.pone.0072924 CrossRefPubMedPubMedCentralGoogle Scholar
- 15.Rosenthal N, Harvey RP (2010) Heart development and regeneration. Academic Press, AmsterdamGoogle Scholar
- 17.Maskatia SA, Pignatelli RH, Ayres NA, Altman CA, Sangi-Haghpeykar H, Lee W (2016) Longitudinal changes and interobserver variability of systolic myocardial deformation values in a prospective cohort of healthy fetuses across gestation and after delivery. J Am Soc Echocardiogr 29:341–349CrossRefPubMedGoogle Scholar
- 19.Di Salvo G, Russo MG, Paladini D, Felicetti M, Castaldi B, Tartaglione A, di Pietto L, Ricci C, Morelli C, Pacileo G, Calabr R (2008) Two-dimensional strain to assess regional left and right ventricular longitudinal function in 100 normal foetuses. Eur J Echocardiogr 9:754–756CrossRefPubMedGoogle Scholar
- 22.Zhang LM, Wang YQ, Wang WY, Li S, Ma CY, Yang J (2016) Assessing interventricular septal function after ventricular septal defect repair by using two-dimensional longitudinal strain and strain rate. Chin J Med Phys 33:805–809Google Scholar