Quantification of radial mechanical dyssynchrony in fetuses with and without right ventricular heart stress due to congenital heart disease by Tissue Doppler Imaging (TDI) echocardiography

Objective: Tissue Doppler Imaging (TDI) echocardiography is a new imaging tool that allows quantification of dyssynchrony in fetuses with and without right ventricular heart stress. An prospective study on fetuses with right heart stress due to congenital heart disease (n=30, group 1) and normal fetuses (n=60, group 2) between the 20th and 40th week of gestation by transversal four chamber view colour TDI cineloop raw data.

Materials and methods: Dyssynchrony was measured offline with TDIQ-Software (Toshiba Medical Systems) as the time difference between the specific changes from the diastolic to the systolic movement of both ventricles by TDI velocity and displacement data.

Results: The measurements were visible in over 95% of cases. The interventricular time difference of group 1 was significant elevated (velocity data: group 1 48±64ms/group 2 21±20ms (p<0,005); displacement data: group 1 79±23ms/group 2 31±24ms (p<0,001)). We identified cut off values for a suspected significant right heart ventricular stress (velocity data: 32ms/specifity. 80%/sensitifity 43%; displacement data: 53ms/specifity 81%/sensitifity 90%).

Conclusion: This is the first report of a quantification of radial mechanical dyssynchrony in fetuses with and without right ventricular heart stress by TDI echocardiography. Assessment by displacement data showed a high specifity and sensitifity. TDI is a usefull new ultrasound tool for quantification and follow-up of the fetal myocardial dyssynchrony to detect significant right ventricular heart stress.