title: Evaluation of right ventricular function in fetal hypoplastic left heart syndrome using spatio-temporal image correlation (STIC).
abstract: BACKGROUND
  Postnatal outcome of fetuses with hypoplastic left heart syndrome (HLHS) is mainly determined by right ventricular function. In the present study we used spatio-temporal image correlation (STIC) to assess right ventricular function of fetuses with HLHS.
  
  
  METHODS
  Three-dimensional ultrasound with STIC technique was used to acquire heart images from fetuses that had HLHS and the normal controls, between 24(+0) and 37(+6) weeks of gestation. Right ventricular end-diastolic volume (RVEDV) and right ventricular end-systolic volume (RVESV) were determined using the virtual organ computer-aided analysis software, and the parameters of right ventricular function were calculated.
  
  
  RESULTS
  Both RVEDV and RVESV were found to be significantly higher in fetuses with HLHS as compared to that in normal controls (P < 0.001). There were no significant differences in the parameters between fetuses with and without a visible left ventricular cavity (P > 0.05). Compared to fetuses with HLHS plus mild tricuspid regurgitation (TR), fetuses with HLHS plus severe TR exhibited lower right ventricular stroke volume (RVSV), right ventricular cardiac output (RVCO) and standardized RVCO (P < 0.05). The right ventricular ejection fraction (RVEF) was significantly lower in HLHS fetuses that had severe TR (P < 0.001).
  
  
  CONCLUSIONS
  As the right ventricle is solely responsible for maintenance of circulation, the right ventricular systolic function undergoes compensatory enhancement in fetuses with HLHS and mild TR, compared to that in normal controls. Size of the left ventricle does not significantly affect the right ventricular function in HLHS. However, right ventricular systolic function may be impaired prenatally in HLHS fetuses that have severe TR.
authors.affiliation: Department of Ultrasound, Second Xiangya Hospital of Central South University, 139 Middle Renmin Rd, 410011, Changsha, Hunan, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Department of Ultrasound, Second Xiangya Hospital of Central South University, 139 Middle Renmin Rd, 410011, Changsha, Hunan, China.
authors.forename: Qichang
authors.initials: Q
authors.lastname: Zhou
authors.affiliation: Department of Obstetrics and Gynecology, Eastern Virginia Medical School, 825 Fairfax Avenue, Norfolk, 23507, VA, USA.
authors.forename: Yili
authors.initials: Y
authors.lastname: Zhao
authors.affiliation: Department of Ultrasound, Second Xiangya Hospital of Central South University, 139 Middle Renmin Rd, 410011, Changsha, Hunan, China. pqh12079@aliyun.com.
authors.forename: Qinghai
authors.initials: Q
authors.lastname: Peng
authors.affiliation: Department of Ultrasound, Second Xiangya Hospital of Central South University, 139 Middle Renmin Rd, 410011, Changsha, Hunan, China.
authors.forename: Zheli
authors.initials: Z
authors.lastname: Gong
authors.affiliation: Department of Ultrasound, Second Xiangya Hospital of Central South University, 139 Middle Renmin Rd, 410011, Changsha, Hunan, China.
authors.forename: Xiangdang
authors.initials: X
authors.lastname: Long
mesh_terms: D000465:Algorithms; D019560:Echocardiography, Three-Dimensional / Q000379:methods*; D005260:Female; D006801:Humans; D018636:Hypoplastic Left Heart Syndrome / Q000000981:diagnostic imaging*; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008297:Male; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D062211:Spatio-Temporal Analysis; D013318:Stroke Volume; D016216:Ultrasonography, Prenatal / Q000379:methods*; D018497:Ventricular Dysfunction, Right / Q000000981:diagnostic imaging*
keywords: Fetal hypoplastic left heart syndrome; Right ventricular function; Spatio-temporal image correlation