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Fetal cardiac function by three-dimensional ultrasound using 4D-STIC and VOCAL – an update Cover

Figures & Tables

Fig. 1.

Myocardial performance index (MPI) or left ventricular Tei index calculated by the formula: MPI = isovolumetric contraction time (IVCT) + isovolumetric relaxation time (IVRT)/ ejection time (ET). The ventricular outflow and inflow values should be obtained by Doppler to measure MPI
Myocardial performance index (MPI) or left ventricular Tei index calculated by the formula: MPI = isovolumetric contraction time (IVCT) + isovolumetric relaxation time (IVRT)/ ejection time (ET). The ventricular outflow and inflow values should be obtained by Doppler to measure MPI

Fig. 2.

Evaluation of the atrioventricular annular movement in the uni-dimensional mode (M-mode) of the echocardiogram. A. MAPSE, mi tral annular plane systolic excursion; B. TAPSE, tricuspid annular plane systolic excursion; C. SAPSE, septal annular plane systolic excursion. LA – left atrium; LV – left ventricle; M – mitral valve; RA – right atrium; RV – right ventricle; S – interventricular septum; T – tricuspid valve
Evaluation of the atrioventricular annular movement in the uni-dimensional mode (M-mode) of the echocardiogram. A. MAPSE, mi tral annular plane systolic excursion; B. TAPSE, tricuspid annular plane systolic excursion; C. SAPSE, septal annular plane systolic excursion. LA – left atrium; LV – left ventricle; M – mitral valve; RA – right atrium; RV – right ventricle; S – interventricular septum; T – tricuspid valve

Fig. 3.

Analysis of myocardial deformity by speckle tracking, which tracks acoustic markers (speckle) and improves the accuracy of the measurements
Analysis of myocardial deformity by speckle tracking, which tracks acoustic markers (speckle) and improves the accuracy of the measurements

Fig. 4.

The stroke volume (SV) can be calculated for each ventricle in the 2D mode by multiplying the valve area of the outflow tract by the mean velocity-time integral (VTI) of the ventricular outflow: SV = ϖr2 × VTI. Ao – aorta; LV – left ventricle; LVOT – left ventricle outflow tract
The stroke volume (SV) can be calculated for each ventricle in the 2D mode by multiplying the valve area of the outflow tract by the mean velocity-time integral (VTI) of the ventricular outflow: SV = ϖr2 × VTI. Ao – aorta; LV – left ventricle; LVOT – left ventricle outflow tract

Fig. 5.

Measurement of the LV cardiac output and ejection fraction using the 4D-STIC and VOCAL software. LV – left ventricle
Measurement of the LV cardiac output and ejection fraction using the 4D-STIC and VOCAL software. LV – left ventricle

Studies evaluating ventricular cardiac function – cardiac output, stroke volume, and ejection fraction – using three-dimensional ultrasound with 4D-STIC and VOCAL

AuthorTotal number of casesGestational age (weeks)Conclusion
Bhat et al. (2004)(35) 90 (in vitro)15–37There was a positive correlation between ventricular mass and gestational age.
Rizzo et al. (2007)(33) 56 (16 with intrauterine growth restrictions and 40 controls)20–34There was good agreement between the measurements of the ventricular cardiac volumes using 4D-STIC with VOCAL and 2D- ultrasound with Doppler.
Messing B et al. (2007)(36) 10020–40It was demonstrated that 4D-STIC was simple, highly reproducible, and could be used for assessing fetal cardiac function. Nomograms for ventricular volume, stroke volume, and ejection fraction were established by gestational age. The ratio between RV and LV volumes was 1.4. The stroke volume ranged from 0.78 to 5.50 cm3, and the ejection fraction ranged from 42.5% to 86.0%.
Molina et al. (2008)(14) 14012–34There was a positive correlation of stroke volume and CO of both ventricles with gestational age.
Hamill et al. (2009)(37) 4419–40VOCAL had good reproducibility for measuring cardiac volumes.
Uittenbogaard et al. (2010)(38) 76 (in vitro) 4D-STIC was shown to be a viable and accurate method for calculating volumes from 0.30 mL. In vitro, 4D-STIC combined with the 3D slice method was more accurate, less time-consuming, and more reliable than VOCAL.
Rizzo et al. (2010)(34) 45 (15 with congenital heart disease and 30 healthy controls)19–32The authors compared ventricular volumes obtained by 4D-STIC with VOCAL and with sonography-based automated volume count (SonoAVC). The time necessary to measure volumes using SonoAVC was significantly shorter than that of the two other methods. However, SonoAVC and VOCAL results were similar. One limitation of the study was the small sample size.
Simioni et al. (2011)(39) 26520–34Reference curves were constructed for stroke volume, CO, and ejection faction according to GA. Stroke volume and CO were positively correlated with GA.
Hamill et al. (2011)(28) 18419–42RV diastolic and systolic volumes were larger than LV volumes. LV ejection fraction was larger than RV ejection fraction. Stroke volume and CO increased with GA, without significant differences between the LV and RV.
Schoonderwald et al. (2012)(40) 30 (84 acquired volumes – 54 excluded volumes)20–34Cardiac volume, stroke volume, and ejection fraction were compared using Simpson’s and VOCAL methods, and both methods were highly reproducible. The small sample size was considered a limitation to use 4D-STIC in clinical practice. *Strict criteria were adopted to include high-quality images of cardiac volumes.
Simioni et al. (2012)(41) 216 (108 fetuses of each sex)20–24There were no significant sex differences in CO and ejection fraction.
DeKoninck et al. (2012)(42) 1516, 24, and 24There was good reproducibility of 3D ultrasonography with 4D-STIC for measuring CO when compared to 2D- Doppler ultrasonography. 4D-STIC combined with SonoAVC and the inversion mode showed higher intra- and interobserver reproducibility than 4D-STIC combined with VOCAL.
Hamill et al. (2013)(43) 3420–36There was an inverse correlation between ventricular CO and vascular resistance of the umbilical artery using 4D-STIC and VOCAL.
Rolo et al. (2015)(44) 20018–334D-STIC with VOCAL was highly reproducible and was used to calculate the volumes of the IVS by GA.
Barros et al. (2015)(45) 37120–334D-STIC and VOCAL was highly reproducible and was used to construct reference curves for the volumes of the ventricular walls of the fetal heart by GA.
Araujo Júnior et al. (2016)(46) 17020–334D-STIC and VOCAL was used to construct reference curves for atrial wall volumes of the fetal heart.
DOI: https://doi.org/10.15557/jou.2019.0043 | Journal eISSN: 2451-070X | Journal ISSN: 2084-8404
Language: English
Page range: 287 - 294
Submitted on: Jul 25, 2019
Accepted on: Oct 16, 2019
Published on: Dec 31, 2019
Published by: MEDICAL COMMUNICATIONS Sp. z o.o.
In partnership with: Paradigm Publishing Services
Publication frequency: 4 issues per year

© 2019 Nathalie Jeanne Bravo-Valenzuela, Alberto Borges Peixoto, Milene Carvalho Carrilho, Ana Letícia Siqueira Pontes, Caroline Cevante Chagas, Christiane Simioni, Edward Araujo Júnior, published by MEDICAL COMMUNICATIONS Sp. z o.o.
This work is licensed under the Creative Commons Attribution 4.0 License.