Evaluation of effect of aortic arch anomalies on fetal cardiac function with the technology of spatio - temporal image correlation / 中华实用儿科临床杂志

ABSTRACT

Objective To evaluate the cardiac function of fetuses with aortic arch anomalies using spatio -temporal image correlation (STIC). Methods Thirty - two fetuses with aortic arch anomalies in Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine from March 2015 to October 2016,were included. These fetuses were divided into 2 groups according to hemodynamicsobstructive lesion group(17 cases)and non - obstructive lesion group(15 cases). Comparative analysis of cardiac function of these fetuses was conducted in light of gestational age - matched normal fetuses separately using fetal echocardiography and STIC. The indexes were obtained,which in-cluded diameter of great arteries,left ventricular end diastolic dimension(LVDD),right ventricular end diastolic dimen-sion(RVDD),right ventricular end systolic transverse diameter(RVDS),left ventricular end systolic transverse diame-ter(LVDS),fractional shortening (FS),left ventricular end - diastolic volume(LVEDV),right ventricular end - dias-tolic volume (RVEDV),left ventricular end - systolic volume (LVESV),right ventricular end - systolic volume (RVESV),stroke volume(SV)and ejection fraction(EF)were obtained. Comparison was made between the groups. Results Cardiac function of fetuses with aortic arch anomalies was within normal range,however,FS and EF were lower in these fetuses than those of normal ones,specifically,the development of aorta was worse in fetuses with obstruc-tive lesions (all P < 0. 05). In these fetuses,RVEDV was larger than that of normal fetuses. EDV and SV were larger in the right ventricle(RV)than those of the left ventricle(LV)[RVEDV vs. LVEDV(1. 681 ± 0. 725)mL vs. (1. 181 ± 0. 565)mL,SV of RV vs. SV of LV(1. 020 ± 0. 436)mL vs. (0. 643 ± 0. 299)mL],and the differences were all sta-tistically significant(t = - 2. 246,P = 0. 032;t = - 2. 939,P = 0. 006);and EF was higher in RV[EF of RV vs. EF of LV(61 ± 5)％ vs. (54 ± 5)％],and the difference was statistically significant(t = - 3. 708,P = 0. 001). Meanwhile, aorta and pulmonary artery were both smaller in fetuses with non - obstructive lesions than those of normal fetuses,and the differences were all statistically significant(all P < 0. 05). There were no significant differences between these fetu-ses and normal fetuses in LVDD,LVDS,RVDD,RVDS or RVDD/ LVDD,and there was no significant difference be-tween LV and RV in volumic indices (all P > 0. 05). Conclusions Small aorta and ventricular disproportion may appear in fetuses with aortic arch obstruction. Though ventricular systolic function is within normal range,FS and EF are lower in aortic arch anomaly fetuses than those in normal fetuses. Aortic arch anomalies may have influence on fetal car-diac function.