Evaluation of the right and left ventricles: An integrated approach measuring the area, length, and width of the chambers in normal fetuses

IntroductionThe purpose of this study was to simultaneously measure with speckle tracking software the end-diastolic ventricular area (A), basal transverse width (BW), mid-chamber transverse width (MW), and basal-apical length (BAL) in normal fetuses and those with pathology. MethodsThe 4-chamber view of the fetal heart was obtained in 200 control fetuses between 20 and 40weeks of gestation and in 9 third-trimester fetuses with heart malformations. The mean and standard deviation for the A, BW, MW, and BAL were computed from the control fetuses and Z scores computed from the 9 fetuses with cardiac malformations. ResultsThe A, BAL, BW, and MW were correlated with 7 somatic and age-independent variables (R-2=.63-.85). The highest R-2 values occurred for the head circumference, estimated fetal weight, and ultrasound mean gestational age (.82-.85). Z-score values and centiles from the 9 fetuses with cardiac malformations suggested that the A, BW, MW, and BAL were below or above the 5th and 95th centiles as expected for the corresponding ventricular pathology. ConclusionsThis study reports an integrated approach to evaluate the end-diastolic size of the right and left ventricular chambers and demonstrated clinical utility in fetuses with cardiac malformations.