Fetal cardiac function by mitral and tricuspid annular plane systolic excursion using spatio-temporal image correlation M‐mode and left cardiac output in fetuses of pregestational diabetic mothers

Figures

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  Fig. 1. Measurement of the fetal left ventricle (LV) volume using spatio-temporal image correlation and virtual organ computer-aided analysis (VOCAL) methods in a fetus from pregestational diabetes mellitus at 22 weeks and 5 days of gestation (LV diastolic volume=0.48 cm3 and heart rate [HR]=166 bpm). The LV cardiac output (LV CO) and LV ejection fraction (LVEF) were calculated from the measurements of the ventricular volumes according to the following formulas: LV CO=(LVDv−LVSv)×HR and LVEF (LVDv−LVSv)/LVDv. The calipers were positioned on the internal border of the mitral valve and on the ventricular endocardial border to perform the manual delimitation of the internal left ventricular volume. After 6 sequential planes, the VOCAL software provided the chamber volume and the reconstructed 3D image. LVDv, left diastolic volume; LVSv, left systolic volume.

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  Fig. 2. In the apical four-chamber view of the fetal heart, the spatio-temporal image correlation in M-mode image is positioned at the junction between the free ventricular wall and the atrioventricular valve for the calculation of mitral annular plane systolic excursion (MAPSE) (A) and tricuspid annular plane systolic excursion (TAPSE) (B) annular plane systolic excursions. MAPSE=5.4 mm; TAPSE=5.4 mm.

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  Fig. 3. Scatter plot of the correlation between tricuspid annular plane systolic excursion (TAPSE) (A), mitral annular plane systolic excursion (MAPSE) (B), left ventricle cardiac output (LV CO) (C), right ventricle cardiac output (RV CO) (D), and fetal heart rate (FHR).

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  Fig. 4. Scatter plot of the correlation between mitral annular plane systolic excursion (MAPSE) and left ventricle cardiac output (LV CO) (A) and correlation between tricuspid annular plane systolic excursion (TAPSE) and right ventricle cardiac output (RV CO) (B).