2025/10/31 by Guihong Chen, Xiang Wei, Wei Xiang +9
Biochemistry, Genetics and Molecular Biology · Medicine · #Congenital Heart Disease Studies #Congenital heart defects research #Metabolism and Genetic Disorders
paper · doi:10.1111/echo.70328
openalex created_date 2025/10/31 · openalex publication_date 2025/10/31 · openalex updated_date 2026/05/21
PURPOSE: To investigate the cardiac function and myocardial strain in fetuses with coarctation of the aorta (CoA) using speckle tracking echocardiography. MATERIALS AND METHODS: Fetuses with and without CoA were prospectively enrolled to undergo a prenatal ultrasound scan for the presence of CoA. The ultrasound parameters were compared between CoA fetuses and normal controls. RESULTS: Forty-five CoA fetuses and 336 normal fetuses matched (p > 0.05) in the gestational age, estimated body weight, and pregnant women's age were enrolled. The CoA fetuses had significant (p < 0.05) decreases in the diameters of the aortic arch and isthmus, the left ventricle (LV) stroke volume and its ratio to the estimated body weight, the LV cardiac output and its ratio to the estimated body weight, the LV EF, the LV end-diastolic and end-systolic volume, area, length and basal segment diameter, the right ventricle (RV) end-diastolic (ED) length, the 4CV global sphericity index (GSI), LV and RV fraction of area change (FAC), LV endocardial global longitudinal strain (EndoGLS) and circumferential strain, RV EndoGLS and free wall strain. In the CoA fetuses, significant (p < 0.05) decreases were detected in the fraction of shortening (FS) and FS Z-score in the LV middle and apical segments and in the RV middle segments, and in the FS Z-score in the RV basal segments. In the CoA fetuses, significant (p < 0.05) increases were detected in the GSI and GSI Z-score in the LV apical part, in the ED diameter and its Z-score in the RV basal and middle parts, whereas significant (p < 0.05) decreases in the GSI and GSI Z-score in all the RV basal, middle and apical parts and in the ED diameter and its Z-score in all the LV basal, middle and apical parts. The LV apical ED diameter (2.30 ± 1.13, OR 9.97, 95% CI 1.16-107.89), LV endocardial GCS (-0.30 ± 0.14, OR 0.74, 95% CI 0.55-0.95), LV FAC (-1.17 ± 0.45, OR 0.31, 95% CI 0.13-0.74), and 4CV GSI (-11.69 ± 5.60, OR 8.34e-6, 95% CI 4.51e-11-0.22) were significant (p < 0.05) independent risk factors. The ROC curve analysis of the multivariate regression model for predicting CoA presence revealed an AUC of 0.973, a sensitivity value of 0.977, and a specificity of 0.888. CONCLUSION: The cardiac function, anatomical parameters, longitudinal and circumferential strain, FS and GSI, LV end-diastolic diameter, and their Z-scores significantly decrease in CoA fetuses, which may assist in differentiating CoA fetuses from normal controls.