Investigating fetal myocardial function in heart anomalies by Doppler myocardial performance indices

Ahsan H. Khandoker, Haitham M. Al-Angari , F. Marzbanrad, Y. Kimura

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Fetal myocardial performance index are used to assess aspects of systolic and diastolic function in developing fetal heart. The aim of this study was to determine normal values of fetal left ventricular (LV) Tei Index (TI) for measuring systolic performance and K-Index (KI) for diastolic performance in early (<32 weeks), Mid (32-35 weeks) and late trimester (35-41 weeks) normal fetuses and fetuses with congenital heart diseases (CHD). Simultaneous recordings of Doppler Ultrasound Signal (DUS) of the LV outflow tracts and fetal electrocardiogram signals were obtained in 57 normal and 14 fetuses with CHD. CHDs were categorized in two types (conduction pathway abnormalities [8 cases] and structural anomalies [6 cases]). The LV isovolumic contraction time (ICT), isovolumic relaxation time (IRT), ventricular ejection time (VET) and ventricular filling time (VFT) were measured from amplitudes and peaks of high frequency component of DUS signals by an automated model. The TI and the new index were calculated by using the formula (ICT + IRT)/VET and (ICT + IRT)/VFT respectively. The TI did not show any significant change from CHD (conduction) to CHD (structural) fetuses (0.72± 0.09 vs 0.76±0.02; NS). On the other hand, KI showed significant decline in values (0.82±0.24 vs 0.49±0.34; p<0.05) during normal development period and CHD with structural anomalies particularly. The correlation of KI with gestational ages was found to be negative and significant (r=- 0.29; p=0.025). Both TI and KI can be easily obtained in the fetus from DUS recording without the need for precise anatomic imaging. In conclusion, KI may be a useful tool to explore the healthy development of fetal myocardial function and identify fetuses with CHD (structural). More research is needed to check if KI could recognize the compromised fetuses from normal ones in future.

Original languageEnglish
Title of host publication2017 39th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC 2017)
EditorsEung Je Woo, Yuan-ting Zhang, Thomas Penzel
Place of PublicationPiscataway NJ USA
PublisherIEEE, Institute of Electrical and Electronics Engineers
Number of pages4
ISBN (Electronic)9781509028092
ISBN (Print)9781509028108
Publication statusPublished - 13 Sept 2017
EventInternational Conference of the IEEE Engineering in Medicine and Biology Society 2017 - Jeju Island, Korea, South
Duration: 11 Jul 201715 Jul 2017
Conference number: 39th (Proceedings)


ConferenceInternational Conference of the IEEE Engineering in Medicine and Biology Society 2017
Abbreviated titleEMBC 2017
Country/TerritoryKorea, South
CityJeju Island
Internet address

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