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. 2023 Oct 4;23(1):488.
doi: 10.1186/s12872-023-03524-0.

Assessment of fetal intraventricular diastolic fluid dynamics using ultrasound vector flow mapping

Qinglan Shu #  1   2 , Yi Wang #  1   2 , Xinyi Lin  3 , Shenghua Xie  1   2 , Zhengyang Wang  1   2 , Sijia Wang  1   2 , Lixue Yin  4   5
Affiliations

Assessment of fetal intraventricular diastolic fluid dynamics using ultrasound vector flow mapping

Qinglan Shu et al. BMC Cardiovasc Disord. .

Retraction in

Abstract

Objective: The purpose of this study was to investigate the feasibility of visualizing and quantifying the normal pattern of vortex formation in the left ventricle (LV) and right ventricle (RV) of the fetal heart during diastole using vector flow mapping (VFM).

Methods: A total of 36 healthy fetuses in the second trimester (mean gestational age: 23 weeks, 2 days; range: 22-24 weeks) were enrolled in the study. Color Doppler signals were recorded in the four-chamber view to observe the phase of the diastolic vortices in the LV and RV. The vortex area and circulation were measured, and parameters such as intraventricular pressure difference (IVPD), intraventricular pressure gradient (IVPG), and average energy loss (EL_AVG) were evaluated at different diastolic phases, including isovolumic relaxation (D1), early diastole (D2), and late diastole (D3).

Results: Healthy second-trimester fetal vortex formations were observed in both the LV and RV at the end of diastole, with the vortices rotating in a clockwise direction towards the outflow tract. There were no significant differences in vortex area and circulation between the two ventricles (p > 0.05). However, significant differences were found in IVPD, IVPG, and EL_AVG among the diastolic phases (D1, D2, and D3) (p < 0.05). Trends in IVPD, IVPG, and EL_AVG during diastole (D1-D2-D3) revealed increasing IVPD and EL_AVG values, as well as decreasing IVPG values. Furthermore, during D3, the RV exhibited significantly higher IVPD, IVPG, and EL_AVG compared to the LV (p > 0.05).

Conclusion: VFM is a valuable technique for analyzing the formation of vortices in the left and right ventricles during fetal diastole. The application of VFM technology has the potential to enhance the assessment of fetal cardiac parameters.

Keywords: Echocardiography; Energy loss; Hemodynamics; Intraventricular pressure gradients; Vector flow mapping; Vortex.

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Conflict of interest statement

None declared.

Figures

Fig. 1
Fig. 1
Left and right ventricular vortex and corresponding time-flow curve of a healthy foetus in average gestational age of 23 weeks
Fig. 2
Fig. 2
IVPD, and EL_AVG in different phases (D1-D2-D3) of left ventricular diastole in the healthy second-trimester foetus D1: isovolumic relaxation period; D2: early diastole; D3: late diastole; each column is D1, D2, and D3 from top to bottom; A-C: the absolute values of IVPD and IVPG in different phases of left ventricular diastole (D1-D2-D3) show a decreasing-increasing trend; D -F: different phases of left ventricular diastole Phase (D1-D2-D3) EL_AVG showed an increasing trend
Fig. 3
Fig. 3
IVPD, and EL_AVG in different diastolic phases (D1-D2-D3) of the right ventricle of the healthy second-trimester foetus D1: isovolumic relaxation period; D2: early diastole; D3: late diastole; IVPD: intraventricular pressure differences; IVPG: intraventricular pressure gradients; EL_AVG: average energy loss; each column is D1, D2, D3 from top to bottom; A-C: Absolute values of IVPD and IVPG in different phases of right ventricular diastole (D1-D2-D3) showed a decreasing-increasing trend; D-F: EL_AVG in different phases of right ventricular diastole (D1-D2-D3) showed an increasing trend
Fig. 4
Fig. 4
Comparison of IVPG and EL in the diastolic period of the left ventricle and right ventricle of a healthy second-trimester fetus D1: isovolumic relaxation period; D2: early diastole; D3: late diastole; IVPD: intraventricular pressure difference; IVPG: intraventricular pressure gradient; EL_AVG: average energy loss; A and B: IVPG and EL in the diastolic period of the left ventricle; C and D: IVPG and EL in the diastolic period of the right ventricle
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