Key result
Fetuses with transposition of the great arteries exhibited significantly impaired right ventricular global longitudinal systolic strain compared to normal controls (-14.35% in d-TGA and -13.04% in TBA vs -18.73%, P<0.001).
Why the study?
To evaluate RV systolic function in fetuses with TGA using velocity vector imaging and investigate the impact of different factors on RV systolic function.
Does velocity vector imaging detect impaired right ventricular systolic function in fetuses with transposition of the great arteries compared to normal controls?
Cross-Sectional (n=127)
No
Does velocity vector imaging detect impaired right ventricular systolic function in fetuses with transposition of the great arteries compared to normal controls?
Absolute Event Rate: -14.35% vs -18.73%
p-value: p=<0.001
Velocity vector imaging demonstrates that early impairment of right ventricular systolic function occurs in fetuses with transposition of the great arteries during the second trimester, with pulmonary stenosis and ventricular septal defect acting as independent risk factors.
Objectives The aim of this study was to evaluate right ventricular (RV) systolic function in fetuses with transposition of the great arteries (TGA) using velocity vector imaging (VVI) and to investigate the impact of different factors on RV systolic function in TGA fetuses. Methods This was a retrospective cross-sectional study of fetuses referred to our tertiary center between 2015 and 2019. Maternal and fetal baseline characteristics and conventional echocardiographic and myocardial deformation indices were collected in fetuses with TGA at 20–28 weeks’ gestation, which were compared with normal fetuses with comparable gestational age (GA). RV deformational parameters including global and regional longitudinal peak systolic strain, strain rate, and velocity were measured using off-line speckle tracking analysis. The univariate and multivariate linear regression analyses were established to evaluate the independent risk factors for RV global longitudinal systolic strain (RVGLSs) and strain rate (RVGLSRs). Results In total, 78 fetuses with TGA [including 49 fetuses with complete transposition of the great arteries (d-TGA) and 29 fetuses with Taussig-Bing anomaly (TBA)] and 49 normal fetuses were included. Compared with normal controls, global and most regional RV longitudinal systolic peak velocity, strain, and strain rate were lower in d-TGA and TBA fetuses (P < 0.05). Compared with normal controls, global and most regional RV longitudinal systolic strain was lower in d-TGA fetuses without pulmonary stenosis (PS) and ventricular septal defect (VSD), while RVGLSs and RVGLSRs were lower in TBA fetuses without PS. The VSD was an independent determinant of RVGLSRs (P = 0.024) in the d-TGA group. Additionally, PS was an independent determinant of RVGLSs and RVGLSRs (P = 0.012, P = 0.027) in the TBA group. Conclusion Early impairment of RV systolic function has already occurred in TGA fetuses during the 2nd trimester of pregnancy. PS, VSD, and foramen ovale (FO) were independent risk factors for decreased RV function.
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Lin et al. (2023) conducted a cross-sectional in Transposition of the great arteries (n=127). Transposition of the great arteries vs. Normal fetuses was evaluated on Right ventricular global longitudinal systolic strain (RVGLSs) (p=<0.001). Fetuses with transposition of the great arteries exhibited significantly impaired right ventricular global longitudinal systolic strain compared to normal controls (-14.35% in d-TGA and -13.04% in TBA vs -18.73%, P<0.001).
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