Evaluation of Ventricular Myocardial Velocities and
Heart Motion of the Fetal Heart by Tissue Doppler
Imaget
VACHARA JAMJUREERUK,M.D.*
Affiliation : * Bangkok Heart Institute, Bangkok General Hospital, Bangkok 10230, Thailand.
t Part of this paper was presented during the 4th World Congress of Echocardiography and Vascular Ultrasound, Cairo,
Egypt 2000.
AbstractFetal echocardiogram has developed into a reliable tool for prenatal diagnosis of con
genital heart disease. It is also used to evaluate ventricular function. Recently, Tissue Doppler
Imaging (TDI) has been introduced to evaluate ventricular functions especially in ischaemic heart
disease. The objective of this study was to evaluate myocardial velocities and heart motions of
the normal fetal heart by using TDI. The TDI was preformed in 28 fetal hearts with a gestational
age of 20-35 wks (Mean 29±3.7 wks) to evaluate myocardial velocities and heart motion. The
Toshiba, Power Vision, machine with 3.75 and 5 MHz transducers was used with an appropriate
setting of colour-coded tissue velocities. The apical four chamber and apical or parasternal long
axis views were the standard planes for measuring myocardial velocities and evaluating the heart
motions. The results showed the myocardial velocities of the posterior wall of the left ventricle
during the early, mid, and late systolic phases were 1.5±0.2, 2.1±0.9, and 1.0±0.5 em/sec and
early, mid, and late diastolic phases were 1.3±0.7, 1.9±0.8, and 1.1±0.7 em/sec respectively. The
myocardial velocity of the anterior wall of the right ventricle during the early, mid, and late systolic
phases were 1.7±0.9, 1.7±0.6, and 1.0±0.6 em/sec and early, mid, and late diastolic phases were
1.1±0.6, 1.8±0.7, and 1.5±1.0 em/sec respectively. The myocardial velocity of the interventri
cular septum could not be measured due to the abnormal septal motion and the total fetal heart
movement during the cardiac cycle. The fetal heart had anterior displacement during systole and
posterior translation during diastole and also had counter-clockwise rotation during the systolic
phase.
Conclusion : Using the TDI to evaluate myocardial velocities of the fetal heart is limited by
the angle of ultrasound beam and the total fetal heart motion. The fetal heart movement is similar
to the newborn or young adult heart.
Keywords : Tissue Doppler Image (TDI), Fetal Echocardiogram, Myocardial Velocities
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