Key result
Hypoplastic left heart syndrome in human fetuses is characterized by a significantly underdeveloped left ventricle and altered hemodynamics, including increased peak valvular flow velocities and wall shear stress, compared to healthy hearts.
Why the study?
The occurrence of CHDs in families without a history of them suggests mechanobiological forces may influence initiation and progression, and comparing healthy and HLHS hearts helps clarify related hemodynamic differences.
Do hemodynamic and structural parameters differ between normally growing and hypoplastic left heart syndrome-diagnosed human fetal hearts?
Observational (n=30)
Do hemodynamic and structural parameters differ between normally growing and hypoplastic left heart syndrome-diagnosed human fetal hearts?
HLHS fetal hearts exhibit significant structural underdevelopment of the left ventricle and markedly altered hemodynamics, including elevated valvular velocities and wall shear stress, compared to healthy fetuses.
Congenital heart defects (CHDs) affect a wide range of societies with an incidence rate of 1.0-1.2%. These defects initiate at the early developmental stage and result in critical health disorders. Although genetic factors play a role in the formation of CHDs, the occurrence of cases in families with no history of CHDs suggests that mechanobiological forces may also play a role in the initiation and progression of CHDs. Hypoplastic left heart syndrome (HLHS) is a critical CHD, which is responsible for 25-40% of all prenatal cardiac deaths. The comparison of healthy and HLHS hearts helps in understanding the main hemodynamic differences related to HLHS. Echocardiography is the most common imaging modality utilized for fetal cardiac assessment. In this study, we utilized echocardiographic images to compare healthy and HLHS human fetal hearts for determining the differences in terms of heart chamber dimensions, valvular flow rates, and hemodynamics. The cross-sectional areas of chamber dimensions are determined from 2D b-mode ultrasound images. Valvular flow rates are measured via Doppler echocardiography, and hemodynamic quantifications are performed with the use of computational fluid dynamics (CFD) simulations. The obtained results indicate that cross-sectional areas of the left and right sides of the heart are similar for healthy fetuses during gestational development. The left side of HLHS heart is underdeveloped, and as a result, the hemodynamic parameters such as flow velocity, pressure, and wall shear stress (WSS) are significantly altered compared to those of healthy hearts.
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Salman et al. (2022) conducted an observational in Hypoplastic Left Heart Syndrome (n=30). Hypoplastic Left Heart Syndrome vs. Normally growing (healthy) fetal hearts was evaluated on Left ventricular cross-sectional area between week 23 and week 31 (p=0.0485). Hypoplastic left heart syndrome in human fetuses is characterized by a significantly underdeveloped left ventricle and altered hemodynamics, including increased peak valvular flow velocities and wall shear stress, compared to healthy hearts.
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