Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Reference values for fetal tissue velocity imaging and a new approach to evaluate fetal myocardial function
KTH, School of Technology and Health (STH), Medical Engineering.
KTH, School of Technology and Health (STH), Medical Engineering.ORCID iD: 0000-0002-5156-2535
KTH, School of Technology and Health (STH), Medical Engineering.
CFM, Karolinska Universitetssjukhuset.
Show others and affiliations
2013 (English)In: Cardiovascular Ultrasound, ISSN 1476-7120, E-ISSN 1476-7120, Vol. 11, no 1, 29- p.Article in journal (Refereed) Published
Abstract [en]

Objectives: Myocardial function can be evaluated using color-coded tissue velocity imaging (TVI) to analyze the longitudinal myocardial velocity profile, and by expressing the motion of the atrioventricular plane during a cardiac cycle as coordinated events in the cardiac state diagram (CSD). The objective of this study was to establish gestational age specific reference values for fetal TVI measurements and to introduce the CSD as a potential aid in fetal myocardial evaluation. Methods: TVI recordings from 125 healthy fetuses, at 18 to 42 weeks of gestation, were performed with the transducer perpendicular to the apex to provide a four-chamber view. The myocardial velocity data was extracted from the basal segment of septum as well as the left and right ventricular free wall for subsequent offline analysis. Results: During a cardiac cycle the longitudinal peak velocities of septum increased with gestational age, as did the peak velocities of the left and right ventricular free wall, except for the peak velocity of post ejection. The duration of rapid filling and atrial contraction increased during pregnancy while the duration of post ejection decreased. The duration of pre ejection and ventricular ejection did not change significantly with gestational age. Conclusion: Evaluating fetal systolic and diastolic performance using TVI together with CSD could contribute to increase the knowledge and understanding of fetal myocardial function and dysfunction. The pre and post ejection phases are the variables most likely to indicate fetuses with abnormal myocardial function.

Place, publisher, year, edition, pages
2013. Vol. 11, no 1, 29- p.
Keyword [en]
Color-coded tissue velocity imaging, Fetus, Myocardium, Normal reference values, Cardiac state diagram, Atrioventricular plane displacement, Myocardial time interval, Longitudinal myocardial peak velocity
National Category
Medical Image Processing
Identifiers
URN: urn:nbn:se:kth:diva-120778DOI: 10.1186/1476-7120-11-29ISI: 000323452000001Scopus ID: 2-s2.0-84881513349OAI: oai:DiVA.org:kth-120778DiVA: diva2:616322
Note

QC 20130912. Updated from submitted to published.

Available from: 2013-04-16 Created: 2013-04-16 Last updated: 2017-12-06Bibliographically approved
In thesis
1. Prenatal Tisse Velocity Imaging of the Heart: A new approach to assess fetal myocardial function
Open this publication in new window or tab >>Prenatal Tisse Velocity Imaging of the Heart: A new approach to assess fetal myocardial function
2013 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The general aim of this thesis has been to evaluate color‐coded tissue velocity imaging (TVI) as an approach to developing a new, non‐invasive assessment method for fetal myocardial function. Such a method could hypothetically give early indications of fetal pathology, as myocardial dysfunction is often the consequence when the circulation tries to adapt to deteriorating situations. This would be beneficial in clinical decision making when evaluating fetal well‐being in a wide range of pregnancy associated conditions, to facilitate risk assessment and to monitor the benefit of therapeutic interventions.

TVI is an ultrasound technique that enables quantification of longitudinal myocardial motion with high temporal resolution, which is essential in the identification of fetal myocardial movements of short duration. Furthermore, the longitudinal motion is mainly determined by subendocardial fibers that usually become abnormal in the very early stages of cardiac dysfunction as they are sensitive to milder degrees of hypoxia. Thus, TVI has the potential to give early indications of impaired fetal myocardial function and hypothetically facilitate the detection of intrauterine hypoxia. Hypoxia is a common phenomenon of many pathological conditions in pregnancy, from which a substantial number of children either die or acquire permanent brain injury during delivery every year.

After having established optimal sampling requirements and ensured an acceptable reproducibility for TVI measurements of the fetal myocardium, normal reference values were determined feasible and sensitive enough to provide insight into maturational changes in myocardial function. This provided a foundation that should enable further investigations and was partly accomplished using the cardiac state diagram (CSD) to accurately time the myocardial events during a cardiac cycle according to the motion shifts of the atrioventricular plane.

The demonstrated results are promising and the general conclusion of this thesis is that TVI contributes to increasing the knowledge and understanding of fetal myocardial function and dysfunction. Used together with CSD this technique has great potential as an assessment method. However, further testing of the clinical potential is needed in larger study populations concerning the pathological or physiological questions at issue, and additional development of the method is required to render the method simple enough to be of potential aid in clinical practice.

Place, publisher, year, edition, pages
Stockholm: KTH Royal Institute of Technology, 2013. xiv, 29 p.
Series
Trita-STH : report, ISSN 1653-3836 ; 2013:3
National Category
Medical Image Processing
Identifiers
urn:nbn:se:kth:diva-120982 (URN)
Public defence
2013-05-07, Sal 4-221, Alfred Nobels allé 12, Huddinge, 13:00 (Swedish)
Opponent
Supervisors
Note

QC 20130419

Available from: 2013-04-19 Created: 2013-04-16 Last updated: 2013-04-19Bibliographically approved

Open Access in DiVA

No full text

Other links

Publisher's full textScopus

Authority records BETA

Johnson, Jonas

Search in DiVA

By author/editor
Elmstedt, NinaJohnson, JonasLind, BrittaBrodin, Lars-Åke
By organisation
Medical Engineering
In the same journal
Cardiovascular Ultrasound
Medical Image Processing

Search outside of DiVA

GoogleGoogle Scholar

doi
urn-nbn

Altmetric score

doi
urn-nbn
Total: 62 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf