Imaging

E1299

JACC March 27, 2012

Volume 59, Issue 13

MYOCARDIAL DEFORMATION OF FETAL RIGHT VENTRICLE IN HYPOPLASTIC LEFT HEART SYNDROME

ACC Moderated Poster ContributionsMcCormick Place South, Hall A

Saturday, March 24, 2012, 11:00 a.m.-Noon

Session Title: Imaging: Echo Cardiomyopathy and Congenital Heart DiseaseAbstract Category: 22. Imaging: Echo

Presentation Number: 1102-495

Authors: Thomas A. Miller, Hsin-Yi Weng, Shaji Menon, University of Utah, Salt Lake City, UT, USA

Background: Assessment of fetal right ventricular (RV) function by 2-D echo is challenging. Velocity vector imaging (VVI) is an angle independent

speckle tracking technique that can assess regional myocardial mechanics. Alteration in deformation of the fetal RV in hypoplastic left heart

syndrome (HLHS) is unknown. The aim of this study was to evaluate the regional myocardial mechanics of the fetal RV in HLHS using VVI.

Methods: HLHS fetuses imaged between 10/07-3/11 were included in this retrospective study. Velocity, strain and strain rate were obtained from

RV free wall and septum in a four chamber view. Parameters of RV deformation were compared between HLHS fetuses and gestational age matched

controls without structural heart disease.

Results: A total of 30 HLHS fetuses and 30 controls were included. The mean gestational age was 31 ±3.8 wks (25 2/7 - 36 5/7). Global and

regional longitudinal strain was significantly decreased in HLHS RVs compared to controls (Figure 1). There was no difference in velocity or strain

rate between the two groups. The volume of the left ventricle did not affect RV deformation.

Conclusions: Compared to controls, the RV in HLHS fetuses has decreased systolic global and regional strain. Prenatal changes in RV deformation

may be responsible for inefficient cardiac performance and output. Impaired RV myocardial performance in HLHS can be measured prenatally and

may be predictive of future RV dysfunction.