title: Real-time 3-dimensional echocardiographic assessment of ventricular volume, mass, and function in human fetuses.
abstract: OBJECTIVE
  We sought to determine the feasibility and reproducibility of real-time 3-dimensional echocardiography (RT3DE) for evaluation of cardiac volume, mass, and function and to characterize maturational changes of these measurements in human fetuses.
  
  
  METHODS
  Eighty pregnant women in the 2(nd) and 3(rd) trimesters (59 with normal fetuses and 21 with fetuses with congenital heart disease [CHD]) were enrolled. We acquired RT3DE images using a matrix-array transducer. RT3DE measurements of volume, mass, stroke volume (SV), combined cardiac output (CCO), and ejection fraction (EF) were obtained. Images were scored and analyzed by two blinded independent observers. Inter- and intraobserver variabilities and correlations between fetal cardiac indices and gestational age were determined.
  
  
  RESULTS
  Fifty-two of 59 normal data sets (88%) and 9 of 21 CHD data sets (43%) were feasible for analysis. In normal fetuses, the right ventricle (RV) is larger than the left ventricle (LV) (P<0.05), but no difference exists between the LV and RV in mass, SV, CO, and CO/CCO. The EFs for the LV and RV were diminished; the RVSV/LVSV was reduced in CHD fetuses compared with normal fetuses (P<0.05). Fetal ventricular volumes, mass, SV, and CCO fit best into exponential curves with gestational age, but LVEF, RVEF, and RVSV/LVSV remain relatively constant.
  
  
  CONCLUSIONS
  RT3DE is feasible and reproducible for assessment of LV and RV volume, mass, and function, especially in normal fetuses. Gestational growth of these measures, except for EF, is exponential in normal and CHD fetuses. CHD fetuses exhibit diminished LV and RV EFs.
authors.affiliation: Pediatric Cardiology, Oregon Health and Science University, Portland, Oregon, United States of America.
authors.forename: Minjuan
authors.initials: M
authors.lastname: Zheng
authors.forename: Micheal
authors.initials: M
authors.lastname: Schaal
authors.forename: Yan
authors.initials: Y
authors.lastname: Chen
authors.forename: Xiaokui
authors.initials: X
authors.lastname: Li
authors.forename: Weihui
authors.initials: W
authors.lastname: Shentu
authors.forename: Pengyuan
authors.initials: P
authors.lastname: Zhang
authors.forename: Muhammad
authors.initials: M
authors.lastname: Ashraf
authors.forename: Shuping
authors.initials: S
authors.lastname: Ge
authors.forename: David J
authors.initials: DJ
authors.lastname: Sahn
mesh_terms: D000293:Adolescent; D000328:Adult; D019560:Echocardiography, Three-Dimensional / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D005333:Fetus / Q000502:physiology*; D006352:Heart Ventricles / Q000196:embryology*; D006801:Humans; D015588:Observer Variation; D009929:Organ Size; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D011263:Pregnancy Trimester, Third; D015203:Reproducibility of Results; D013997:Time Factors; D016276:Ventricular Function / Q000502:physiology*; D055815:Young Adult