Conventional Doppler myocardial performance index, tricuspid and mitral annular plane systolic excursions in the assessment of fetal heart functions

Objective: Tei index and TAPSE & MAPSE are very useful and reliable non-invasive methods to assess the global myocardial systolic and diastolic functions, and right and left ventricular longitudinal myocardial functions, respectively. In this study, we aimed to assess fetal right and left ventricle (RV and LV) functions by myocardial performance index (Tei index) and tricuspid and mitral annular plane systolic excursions (TAPSE and MAPSE). Methods: The findings of fetal echocardiographies performed in our center for control purposes between December 2015 and April 2017 were assessed. By obtaining appropriate positions in 152 fetuses which are at eligible weeks of gestation, Tei index and TAPSE and MAPSE measurements were recorded. Repeating echocardiographies were excluded from the study. Results: Of all fetuses included in the study, LV Tei index was 0.47±0.16, RV Tei index was 0.52±0.17, TAPSE was 0.47±0.1 cm, and MAPSE 0.36±0.07 cm. Seventy-two fetuses were at 20+3–26 weeks of gestation, and 80 fetuses were at 26+3–37+3 weeks of gestation. Both groups were measured separately and they were compared. While there was no significant increase in LV and RV Tei indices and mitral valve gradient during the advanced weeks of gestation, significant difference was observed in TAPSE and MAPSE values (p=0.001 for both). Conclusion: Tei index, and TAPSE and MAPSE are reliable noninvasive methods for global heart functions and annular plane systolic longitudinal functions of right and left ventricles, respectively, which are easily used on fetuses as well as children who are healthy or with congenital heart disease; and these methods also can be used in the routine practice.