Perinatal changes in myocardial function: Speckle Tracking Echocardiography reference values during the transition from fetal to postnatal life from a prospective longitudinal cohort

Objective Speckle Tracking Echocardiography (STE) allows the quantification of myocardial function. Still, changes in the perinatal transition are not yet well described. Therefore, we aimed to establish reference values of perinatal STE derived strains during the transitional from the fetus up unto the full myocardial adaptation of the neonate in a prospective longitudinal cohort.

Methods This is a clinical prospective single-center study of healthy term neonates born from May 2022 onwards at the University Hospital Giessen and Marburg. High frame-rate four chamber-view (4CV) ultrasound videoloops of prenatal examinations shortly before birth as well as early postnatal within 48 hours and late postnatal at 28 days of life were acquired. Speckle tracking analysis was performed for all cardiac chambers.

Results So far 105 healthy neonates have been included in this study. The median gestational age at birth was 39 weeks. The prenatal exam was median 40 hours before birth, early postnatal exam was median 15h after birth, late postnatal exam was median 28 days after birth. For the left ventricle (LV), prenatal mean global longitudinal strain (GLS) was -16,2% (1,93%), early postnatal mean (SD) GLS was -21,7% (1,54%), late postnatal mean (SD) GLS was -21,6% (2,48%). Intra- and interrater testing showed good reliability. Results of all cardiac chambers including left and right ventricle as well as left and right atrium will be evaluated until presentation.

Conclusion STE reference values for the perinatal transition in healthy term fetuses could be established. Intra- and interrater testing confirmed reliable results. A significant decrease of LV-GLS was measured during the transition from the pre- to postnatal period. Further studies are needed to investigate STE values in fetuses with underlying diseases and possible impact on outcome.

Acknowledgements This study was funded by the German Society of Ultrasound in Medicine (DEGUM).

Publication History

Article published online:
15 November 2023