Tricuspid Annular Plane Systolic Excursion In Evaluation Of Right Heart Systolic Function Of Fetuses In Second And Late Trimester With Conventional M-mode And Free Angle M-mode Echocardiograph

Objective:To evaluate the usefulness of free angle M-mode echocardiography (FAM) in obtaining tricuspid annular plane systolic excursion (TAPSE) in order to assess the fetal right ventricular function, and to compare conventional M-mode(CM) and FAM measures of TAPSE.Methods:Two hundred and forty three normal fetuses in second and late trimester were divided into5groups by gestational age:20～24weeks,24+1～28weeks,28+32weeks,32+1～36weeks,36+1～40weeks, the TAPSE were measured by CM and FAM echocardiography, meanwhile multiple parameters for evaluating right ventricular function were obtained by using myocardial Doppler tissue imaging (DTI), and the correlation between TAPSE and other pareamters were analyzed by linear correlation. ANOVA was used to compare CM-TAPSE, FAM-TAPSE, Em, Sm and FS with different gestational age. Regression equation estimate was used to compare the relationship of FAM-TAPSE with gestational age. Independent sample T test was used to compare CM-TAPSE with FAM-TAPSE.Results:There was significant difference in CM-TAPSE, FAM-TAPSE, Em, and Sm among5groups (P=0.000), the measured value of FAM-TAPSE was higher than that of CM-TAPSE (P=0.000), Both FAM-TPASE and CM-TAPSE showed significant positive correlations with GA, Em and Sm, but FAM-TAPSE demonstrated better correlation than CM-TAPSE.Conclusions:By adjusting sample line of FAM we can measure the maximum displacement of tricuspid annular plane, and evaluate fetal right ventricular function more accurately and effectively.