Application Of Fetal HQ Technology In Cardiac Structure And Systolic Function Of Fetal Coarctation Of The Aortic

Objective: The purpose of this study was to evaluate fetal heart structure and systolic function by using fetal technology with Coarctation of the aortic(CoA),compare the differences between fetal heart shape and normal fetal heart,and explore the application value of fetal HQ technology in evaluating cardiac structure and systolic function of CoA and left and right ventricles globally,vertically and horizontally.Methods: 30 fetuses suspected of CoA by fetal echocardiography at the General Hospital of Ningxia Medical University and Peking University First Hospital Ningxia Women and Children’s Hospital from May 2020 to December2022 were randomly selected as the case group,and 60 fetuses with normal single pregnancy in the same period were selected as the normal control group.Fetal HQ software was used to measure and calculate the four-chamber view-end diastolic-length(4CV-ED-L),Four Chamber view-End Diastolic-Transverse Wide(4CV-ED-TW),and the four-chambe r Global Sphericity Index(GSI),left and right ventricular 24-segment End Diastolic Diameter,24-segment Spherical Index SI and Left Ventricle-Fractional Area Change(LV-FAC),left ventricular overall longitudinal strain Left Ventricle-Global Longitudinal Strain(LV-GLS),Right Ventricle-Fractional Area Change(RV-FAC),Right Ventricle-Global Longitudinal Strain(RV-GLS),Left,and Right Ventricle Transverse Fractional Shortening(FS),results were recorded and statistically analyzed.The independent sample t-test was used for each quantitative parameter of the two groups of fetuses that conformed to the normal distribution,and the non-parametric test was used for those that did not conform to the normal distribution.The statistical difference was considered as P<0.05.At the same time,the correlation analysis was performed for the GA and GSI,LV-FAC,LV-GLS,RV-FAC,RV-GLS.Pearson correlation analysis was used for the variables that conformed to the normal distribution,and Spearman correlation analysis was used for the variables that did not conform to the normal distribution.Results:(1)Comparison of general clinical data: the average age of 30 pregnant women in CoA group was(28.70±0.90)years old,and the average gestational age was(29.7±5.3)weeks.The average age of 60 pregnant women in the normal control group was(27.78±0.52)years old,and the average gestational age was(29.9±3.6)weeks.(2)Comparison of morphological parameters of the four-chamber heart between the two groups: compared with the control group,the BAL of the four-chamber heart in the CoA group was shortened,the TW was widened,the GSI was decreased,and the overall shape of the heart tended to be more spherical.(3)Comparison of morphological parameters of left and right ventricles between the two groups: Compared with the control group,the CoA group had a significantly smaller EDD of the 1-24 segments of the left ventricle(P< 0.05),a significantly larger EDD of the 1-24 segments of the right ventricle(P <0.05),a significantly larger SI of the 16-24 segments of the left ventricle(P <0.05),and a significantly smaller SI of the 7-24 segments of the right ventricle(P< 0.05).(4)Compared with the control group,the FAC and GLS of the left and right ventricle were decreased(P < 0.05),the FS of the left ventricle 1-24 segment was decreased,and the FS of the right ventricle 1-16 segment was decreased(P <0.05).(5)Correlation analysis: there was no significant correlation between gestational age and GSI,LV-FAC,LV-GLS,RV-FAC,RV-GLS.(6)Consistency analysis: intra-observer and inter-observer comparisons of the main cardiac function related parameters showed a strong consistency with ICC >0.9.The CV was less than 1%,indicating low variability.Conclusions: 1.There was no significant correlation between fetal GA and GSI,LV-FAC,LV-GLS,RV-FAC,RV-GL in CoA group and control group.2.The GSI of CoA fetus decreases,and the overall shape of the heart is closer to the spherical shape.3.The left ventricular diameter of CoA fetuses decreases,the apical segment sphericity index increases,and the ventricular morphology tends to be flattened;The transverse diameter of the right ventricle increases,while the spherical index of some basal segments,all intermediate segments,and apical segments decreases,resulting in a more spherical ventricular morphology.4.The global,transverse,and longitudinal systolic function of the left ventricle in CoA fetuses is reduced,while the global and longitudinal systolic function of the right ventricle is reduced,and the lateral systolic function of the basal and intermediate segments is reduced.5.Fetal HQ is a new technique with simple operation,rapid analysis and high repeatability,which can quantitatively evaluate the structural and systolic function changes of fetal heart.