Work

Left and Right Ventricular Strain Mechanics in Fetal Tachyarrhythmia

Year: 2025

Type: article

Abstract: Introduction: Assessment of myocardial function in fetuses with supraventricular tachyarrhythmia is challenging. Speckle-tracking echocardiography (STE) is a newer sensitive method to assess ventricular systolic function. We sought to assess left (LV) and right (RV) ventricular myocardial strain mechanics in fetuses with tachyarrhythmia and hypothesized that strain mechanics are impaired in this patient population even after conversion to sinus rhythm. METHODS: This was a single-center retrospective review. LV and RV strain parameters were assessed using STE in tachyarrhythmia and after conversion to sinus rhythm and, compared to gestational age (GA), matched control fetuses in sinus rhythm. RESULTS: Eighteen fetuses with tachyarrhythmia and 18 controls were analyzed at median GA of 31 weeks (range 28-34 weeks). LV Global Longitudinal Strain (GLS) (-4.5% [-5.2, -1.9] vs. -11.2% [-14.6, -9.9]; p value 0.0001), Strain Rate (-0.8% [-1.5, -0.6] vs. -1.7% [-2.5, -1.2]; p value 0.007), and Global Longitudinal Velocity (GLV) (0.7 cm/s [0.5, 1.3] vs. 1.8 cm/s [0.9, 2.1]; p value 0.003) were reduced in tachyarrhythmia and improved with sinus rhythm but remained abnormal compared to controls. RV GLS (-6.3% [-8.5, -5.1] vs. -13.6% [-15.3, -10.6]; p value <0.0001), Strain rate (-1.3% [-1.7, -0.9] vs. -2.1% [-2.5, -1.4]; p value 0.0103), and GLV (1.2 cm/s [0.8, 1.7] vs. 1.9 cm/s [1.2, 2.7]; p value 0.026) were low in tachyarrhythmia and improved with sinus rhythm but remained lower than in controls. Regional strain was decreased in all LV and RV segments in tachyarrhythmia. CONCLUSION: Fetuses in tachyarrhythmia had reduced measures of myocardial deformation that improved with sinus rhythm but remained low compared to matched controls. Future studies are needed to explore the utility of STE for serial monitoring of fetuses in tachyarrhythmia and to assess response to therapy. .

Source: Fetal Diagnosis and Therapy

DOI: 10.1159/000546991

Authors: Rukmini Komarlu, Janelle Noel-MacDonnell, Neha Chellu, Geetha Haligheri

Institutions: Cleveland Clinic, Case Western Reserve University, Children's Mercy Hospital, University of Kansas Medical Center, Johns Hopkins University

Language: English

Topic: Congenital Heart Disease Studies

Subfield: Epidemiology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

OpenAlex ID: W4411449179