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To compare fetal tricuspid annular plane systolic excursion(TAPSEZ-scores and mitral annular plane systolic excursion(MAPSE) Z-scores between fetuses with heart failure (HF) and normal fetuses, and to analysis the correlation between CVPS and annular plane systolic excursion(APSE) Z-score(sum of the TAPSE and MAPSE Z-score) in order to evaluate the ventricle systolic function and severity in fetuses with HF. A total of 1012 normal fetuses and 24 fetuses with heart failure were involved. TAPSE and MAPSE were measured by free angle M-mode(FAM) echocardiography. Normal FAM-TAPSE and FAM-MAPSE Z-score models based on GA were constructed by performing a standard regression analysis followed by weighted regression of absolute residual values . Tei indexes were calculated in all fetuses with heart failure and all of them were divided into left heart failure (LHF)group and right heart failureRHF)group by Tei index. Subsequently, FAM-MAPSE Z-scores were compared between the normal and LHF groups, FAM-TAPSE Z-scores were compared between the normal and RHF groupsFAM-APSE Z-scores (sum of the FAM-TAPSE and FAM-MAPSE Z-score) and the cardiovascular profile scores (CVPS) in 24 fetuses were calculated, the correlation was analyzed among them. The models used to calculate Z-score for FAM-TAPSE and FAM-MAPSE were constructed, and GA had significant correlation with them ( r  = 0.949,  p  &lt; 0.001for all)Compared with normal fetuses, the mean Z-scores of FAM-TAPSE and FAM-MAPSE were statistically significantly different in fetuses with HFIn the HF groups, all FAM-TAPSE and FAM-MAPSE Z-scores(22/22) were &lt;-2. CVPS ranged from 3 to 8 (mean 5.25 out of 10) and correlated positively with FAM-APSE Z-score ( r  = 0.762). The FAM-TAPSE and FAM-MAPSE Z-scores declined in fetuses with HF and they can provide quantitative evidence in evaluation of heart systolic function, FAM-APSE Z-score correlated positively with CVPS. FAM-TAPSE, FAM-MAPSE and FAM-APSE Z-scores would be markers for assessing heart systolic function and severity in fetuses with HF.

Annular plane systolic excursion Z-scores in evaluation of heart systolic function of fetus with heart failure