The International Journal of Cardiovascular Imaging

, Volume 34, Issue 9, pp 1403–1408 | Cite as

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)

  • Li-Juan Zhang
  • Ke-Qi Chen
  • Yun-Yan Shi
  • Xiao-Zhi Zheng
Original Paper


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.


Perimembranous 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.


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© Springer Science+Business Media B.V., part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of UltrasoundPukou Hospital (The Fourth Affiliated Hospital with Nanjing Medical University)NanjingPeople’s Republic of China
  2. 2.Department of Ultrasound, Yancheng Institute of Clinical Medicine (The First People’s Hospital of Yancheng)Xuzhou Medical UniversityYanchengPeople’s Republic of China

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