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Real Time Three‐Dimensional Echocardiographic Evaluations of Fetal Left Ventricular Stroke Volume, Mass, and Myocardial Strain: In Vitro and In Vivo Experimental Study
Author(s) -
Zhu Meihua,
Ashraf Muhammad,
Zhang Zhijun,
Streiff Cole,
Shimada Eriko,
Kimura Sumito,
Schaller Traci,
Song Xubo,
Sahn David J.
Publication year - 2015
Publication title -
echocardiography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.404
H-Index - 62
eISSN - 1540-8175
pISSN - 0742-2822
DOI - 10.1111/echo.12939
Subject(s) - sonomicrometry , in vivo , medicine , stroke volume , cardiology , pulsatile flow , fetus , inferior vena cava , hypervolemia , nuclear medicine , hemodynamics , blood volume , ejection fraction , heart failure , biology , pregnancy , genetics , microbiology and biotechnology
Background Left ventricular stroke volume, mass, and myocardial strain are valuable indicators of fetal heart function. This study investigated the feasibility of nongated real time three‐dimensional echocardiography ( RT 3 DE ) to determine fetal stroke volume ( SV ), left ventricular mass ( LVM ), and myocardial strain under different conditions. Methods To evaluate fetal hearts, fetal‐sized rabbit hearts were used in this study. The in vitro portion of this study was carried out using a balloon inserted into the LV of eight fresh rabbit hearts and driven by a calibrated pulsatile pump. RT 3 DE volumes were obtained at various pump‐set SV s. The in vivo experiments in this study were performed on open‐chest rabbits. RT 3 DE volumes were acquired at the following conditions: baseline, simulated hypervolemia, inferior vena cava ( IVC ) ligation, and ascending aorta ( AAO ) ligation. Displacement values and sonomicrometry data were used as references for RT 3 DE ‐derived SV , LVM , longitudinal strain ( LS ), and circumferential strain ( CS ). Results Excellent correlations between RT 3 DE ‐derived values and reference values were demonstrated and accompanied by high coefficients of determination ( R 2 ) for both in vitro and in vivo studies for SV , LVM , LS , and CS (in vitro: SV : R 2 = 0.98; LVM : R 2 = 0.97; LS : R 2 = 0.87, CS : R 2 = 0.80; in vivo: SV : R 2 = 0.92; LVM : R 2 = 0.98; LS : in vivo: R 2 = 0.84; CS : in vivo: R 2 = 0.76; all P < 0.05). Conclusions RT 3 DE is capable of quantifying the SV , LVM , and myocardial strain of fetal‐sized hearts under different conditions. This nongated RT 3 DE may aid the evaluation of fetal cardiac function, providing a superior understanding of the progress of fetal heart disorders.