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Lin S, Cao H, Hong L, Song X, Liu K, Xie M, Yang Y. Right ventricular systolic function and associated anatomic risk factors in fetuses with transposition of the great arteries: Evaluation by velocity vector imaging. Front Cardiovasc Med 2023; 9:973395. [PMID: 36704461 PMCID: PMC9873346 DOI: 10.3389/fcvm.2022.973395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 12/14/2022] [Indexed: 01/11/2023] Open
Abstract
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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Affiliation(s)
- Shan Lin
- Department of Ultrasound, Hubei No. 3 People’s Hospital of Jianghan University, Wuhan, China
| | - Haiyan Cao
- Department of Ultrasound, Tongji Medical College, Union Hospital, University of Science and Technology, Wuhan, China,Hubei Province Clinical Research Center for Medical Imaging, Wuhan, China,Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
| | - Liu Hong
- Department of Ultrasound, Tongji Medical College, Union Hospital, University of Science and Technology, Wuhan, China,Hubei Province Clinical Research Center for Medical Imaging, Wuhan, China,Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
| | - Xiaoyan Song
- Department of Ultrasound, Tongji Medical College, Union Hospital, University of Science and Technology, Wuhan, China,Hubei Province Clinical Research Center for Medical Imaging, Wuhan, China,Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
| | - Kun Liu
- Department of Ultrasound, Hubei No. 3 People’s Hospital of Jianghan University, Wuhan, China,Kun Liu,
| | - Mingxing Xie
- Department of Ultrasound, Tongji Medical College, Union Hospital, University of Science and Technology, Wuhan, China,Hubei Province Clinical Research Center for Medical Imaging, Wuhan, China,Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China,Mingxing Xie,
| | - Yali Yang
- Department of Ultrasound, Tongji Medical College, Union Hospital, University of Science and Technology, Wuhan, China,Hubei Province Clinical Research Center for Medical Imaging, Wuhan, China,Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China,*Correspondence: Yali Yang,
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