Left ventricular ejection fraction and fractional area change assessed by 2D speckle-tracking echocardiography remained independent of AV conduction time and fetal heart rate, unlike the myocardial performance index.
Observational (n=468)
Does 2D speckle-tracking echocardiography provide fetal left ventricular function quantification (EF and FAC) that is less influenced by atrioventricular conduction time and heart rate compared to myocardial performance index?
In healthy fetuses, left ventricular EF and FAC measured by 2D speckle-tracking echocardiography are more robust measures of ventricular function than MPI, as they are independent of AV conduction time and heart rate variations.
p-value: p=<0.001
ABSTRACT Background Each myocardial function parameter has limitations. The myocardial performance index (MPI) relies solely on cardiac time intervals and appears optimal. However, its accuracy may be compromised in fetuses with prolonged atrioventricular (AV) conduction time and variable fetal heart rate (FHR). We evaluated whether ejection fraction (EF) and fractional area change (FAC), assessed by two‐dimensional speckle‐tracking echocardiography (2D‐STE), are less influenced by AV conduction time and FHR than MPI. Methods We studied 468 fetuses without structural, hemodynamic, or major vessel abnormalities. Fetuses with AV time >90th percentile for the corresponding trimester comprised the study group. MPI and its components, AV time, and FHR were measured using simultaneous left ventricular (LV) inflow and outflow pulsed‐wave Doppler (PWD) recordings. LV EF and FAC were assessed via 2D‐STE. Results AV time correlated strongly with isovolumic contraction time (ICT) in both the second ( r = 0.73, p 0.7), whereas EF and FAC showed no discrimination (AUC ≈0.5). Conclusions This study demonstrated that the LV MPI showed a significant dependence on AV conduction time. In contrast, LV EF and FAC, calculated using 2D‐STE, remained robust and independent of variations in AV conduction time and FHR in healthy fetuses.
Serafin et al. (Sun,) conducted a observational in Healthy fetuses (n=468). 2D speckle-tracking echocardiography (EF and FAC) vs. Myocardial performance index (MPI) was evaluated on Dependence of LV function parameters on AV conduction time and fetal heart rate (p=<0.001). Left ventricular ejection fraction and fractional area change assessed by 2D speckle-tracking echocardiography remained independent of AV conduction time and fetal heart rate, unlike the myocardial performance index.