Document Type

Article

Publication Date

12-2025

Identifier

DOI: 10.1159/000546991; PMCID: PMC12286586

Abstract

Introduction: Assessment of myocardial function in fetuses with supraventricular tachyarrhythmia is challenging. Speckle-tracking echocardiography (STE) is a newer sensitive method to assess ventricular systolic function. We sought to assess left (LV) and right (RV) ventricular myocardial strain mechanics in fetuses with tachyarrhythmia and hypothesized that strain mechanics are impaired in this patient population even after conversion to sinus rhythm.

METHODS: This was a single-center retrospective review. LV and RV strain parameters were assessed using STE in tachyarrhythmia and after conversion to sinus rhythm and, compared to gestational age (GA), matched control fetuses in sinus rhythm.

RESULTS: Eighteen fetuses with tachyarrhythmia and 18 controls were analyzed at median GA of 31 weeks (range 28-34 weeks). LV Global Longitudinal Strain (GLS) (-4.5% [-5.2, -1.9] vs. -11.2% [-14.6, -9.9]; p value 0.0001), Strain Rate (-0.8% [-1.5, -0.6] vs. -1.7% [-2.5, -1.2]; p value 0.007), and Global Longitudinal Velocity (GLV) (0.7 cm/s [0.5, 1.3] vs. 1.8 cm/s [0.9, 2.1]; p value 0.003) were reduced in tachyarrhythmia and improved with sinus rhythm but remained abnormal compared to controls. RV GLS (-6.3% [-8.5, -5.1] vs. -13.6% [-15.3, -10.6]; p value < 0.0001), Strain rate (-1.3% [-1.7, -0.9] vs. -2.1% [-2.5, -1.4]; p value 0.0103), and GLV (1.2 cm/s [0.8, 1.7] vs. 1.9 cm/s [1.2, 2.7]; p value 0.026) were low in tachyarrhythmia and improved with sinus rhythm but remained lower than in controls. Regional strain was decreased in all LV and RV segments in tachyarrhythmia.

CONCLUSION: Fetuses in tachyarrhythmia had reduced measures of myocardial deformation that improved with sinus rhythm but remained low compared to matched controls. Future studies are needed to explore the utility of STE for serial monitoring of fetuses in tachyarrhythmia and to assess response to therapy.

Journal Title

Fetal diagnosis and therapy

Volume

52

Issue

6

First Page

610

Last Page

620

MeSH Keywords

Humans; Female; Retrospective Studies; Pregnancy; Ultrasonography, Prenatal; Echocardiography; Heart Ventricles; Fetal Heart; Case-Control Studies; Ventricular Function, Right; Ventricular Function, Left

PubMed ID

40532670

Keywords

Speckle-tracking echocardiography; Strain; Tachyarrhythmia; Ventricular function

Comments

This article is available under the Creative Commons CC-BY-NC license and permits non-commercial use, distribution and reproduction in any medium, provided the original work is properly cited.

Publisher's Link: https://karger.com/fdt/article/52/6/610/929120/Left-and-Right-Ventricular-Strain-Mechanics-in

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