409f86e2fc30aefb76e41551c53e3398 pmc_10931078.pdf 5c87679409a186c0ad7ab907e2bb5e443cde7dab pmc_10931078.pdf 702e29ed5f83f40e9a9df57c5d7c2c684ac0c51065e63a110eade8333373b4be pmc_10931078.pdf Title: Fetal Left Ventricle Function Evaluated by Two-Dimensional Speckle-Tracking Echocardiography across Clinical Stages of Severity in Growth-Restricted Fetuses Subject: Fetal growth restriction (FGR) can result in adverse perinatal outcomes due to cardiac dysfunction. This study used 2D speckle-tracking echocardiography to assess left ventricle (LV) longitudinal strain across FGR severity stages. A prospective longitudinal cohort study measured global (GLS) and segmental LV longitudinal strain in FGR fetuses, with evaluations conducted at various time points. FGR was classified into subtypes based on published criteria using fetal weight centile and Doppler parameters. A linear mixed model was employed to analyze repeated measures and compare Z-score measurements between groups throughout gestational age. The study included 40 FGR fetuses and a total of 107 evaluations were performed: 21 from small for gestational age (SGA), 74 from the FGR stage I, and 12 from the FGR stage II. The results indicate that SGA and stage I FGR fetuses exhibit higher LV GLS than stages II. Throughout gestation, SGA and FGR stage I fetuses showed similar behavior with consistently better LV GLS values when compared to FGR stages II. No significant differences were observed in LV GLS strain behavior between SGA and FGR stage I. In conclusion, all FGRs show signs of early cardiac dysfunction, with severe cases demonstrating significantly a lower LV GLS when compared to mild cases, suggesting deterioration of cardiac dysfunction with progression of fetal compromise. Keywords: fetal echocardiography; prenatal diagnosis; 2D speckle tracking; strain; fetal growth restriction; fetal cardiac function Author: Carla Domínguez-Gallardo, Nuria Ginjaume-García, Johana Ullmo, Juan Parra, Ana Vázquez, Mónica Cruz-Lemini and Elisa Llurba Creator: LaTeX with hyperref Producer: pdfTeX-1.40.25 CreationDate: Tue Mar 5 07:56:41 2024 CET ModDate: Tue Mar 5 08:00:17 2024 CET Custom Metadata: no Metadata Stream: no Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 12 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 2258174 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- PRJKGQ+VnURWPalladioL-Bold Type 1 Custom yes yes yes 10 0 UTORFU+URWPalladioL-Bold Type 1 Custom yes yes yes 16 0 NJHOBZ+URWPalladioL-Roma Type 1 Custom yes yes yes 22 0 TNITEB+URWPalladioL-Ital Type 1 Custom yes yes yes 27 0 CYQUEQ+CMSY10 Type 1 Builtin yes yes yes 32 0 ARIQJE+VnURWPalladioL Type 1 Custom yes yes yes 37 0 BXZUUH+TimesNewRomanPS-BoldItalicMT Type 1C WinAnsi yes yes no 53 0 JLZORU+EURM10 Type 1 Builtin yes yes yes 73 0 LNNGDO+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 84 0 LNNGDP+PalatinoLinotype CID TrueType Identity-H yes yes yes 87 0 LNNGEA+PalatinoLinotype TrueType WinAnsi yes yes no 93 0 LNNGEC+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 96 0 LNNGKB+PalatinoLinotype TrueType MacRoman yes yes no 99 0 WBVKDJ+URWPalladioL-BoldItal Type 1 Custom yes yes yes 106 0 LAICDK+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 117 0 LAICEL+PalatinoLinotype CID TrueType Identity-H yes yes yes 120 0 LAICEM+PalatinoLinotype TrueType WinAnsi yes yes no 126 0 LAICEO+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 129 0 LAICIN+PalatinoLinotype TrueType MacRoman yes yes no 132 0 DOJJLK+PalatinoLinotype TrueType WinAnsi yes yes no 146 0 Jhove (Rel. 1.28.0, 2023-05-18) Date: 2024-04-10 02:42:08 CEST RepresentationInformation: pmc_10931078.pdf ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2024-03-20 02:30:58 CET Size: 2258174 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 303 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: section.1 Item: Title: Materials and Methods Destination: section.2 Children: Item: Title: Study Population Destination: subsection.2.1 Item: Title: Ultrasound Acquisition Destination: subsection.2.2 Item: Title: Analysis Protocol Destination: subsection.2.3 Item: Title: Statistical Analysis Destination: subsection.2.4 Item: Title: Results Destination: section.3 Children: Item: Title: Basic Characteristics of the Study Population Destination: subsection.3.1 Item: Title: Fetal Ultrasound Assessment Destination: subsection.3.2 Item: Title: Discussion Destination: section.4 Item: Title: Conclusions Destination: section.5 Item: Title: References Destination: appendix.A. Info: Title: Fetal Left Ventricle Function Evaluated by Two-Dimensional Speckle-Tracking Echocardiography across Clinical Stages of Severity in Growth-Restricted Fetuses Author: Carla Domínguez-Gallardo, Nuria Ginjaume-García, Johana Ullmo, Juan Parra, Ana Vázquez, Mónica Cruz-Lemini and Elisa Llurba Subject: Fetal growth restriction (FGR) can result in adverse perinatal outcomes due to cardiac dysfunction. This study used 2D speckle-tracking echocardiography to assess left ventricle (LV) longitudinal strain across FGR severity stages. A prospective longitudinal cohort study measured global (GLS) and segmental LV longitudinal strain in FGR fetuses, with evaluations conducted at various time points. FGR was classified into subtypes based on published criteria using fetal weight centile and Doppler parameters. A linear mixed model was employed to analyze repeated measures and compare Z-score measurements between groups throughout gestational age. The study included 40 FGR fetuses and a total of 107 evaluations were performed: 21 from small for gestational age (SGA), 74 from the FGR stage I, and 12 from the FGR stage II. The results indicate that SGA and stage I FGR fetuses exhibit higher LV GLS than stages II. Throughout gestation, SGA and FGR stage I fetuses showed similar behavior with consistently better LV GLS values when compared to FGR stages II. No significant differences were observed in LV GLS strain behavior between SGA and FGR stage I. In conclusion, all FGRs show signs of early cardiac dysfunction, with severe cases demonstrating significantly a lower LV GLS when compared to mild cases, suggesting deterioration of cardiac dysfunction with progression of fetal compromise. 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