A 24-segment fractional shortening of the fetal heart using HQ.

Objectives: To evaluate 24-segment fractional shortening (FS) of the fetal heart using HQ by speckle-tracking regarding reproducibility and the change with advancing gestation.

Methods: Eighty-one pregnant women at 18-21+6 and 28-31+6 weeks of gestation were studied using HQ with the speckle-tracking technique to calculate 24-segment FS of left and right ventricles. Intra- and inter-class correlation coefficients and intra- and inter-observer agreements of measurements for FS were assessed in each segment.

Results: With respect to intra-observer reproducibility, all FS values showed correlations between 0.575 and 0.862 for the left ventricle, with good intra-observer agreements except for left ventricular segments 14-24. Right ventricular FS values showed correlations between 0.334 and 0.685, with good intra-observer agreements. With respect to inter-observer reproducibility, all FS values showed correlations between 0.491 and 0.801 for the left ventricle, with good intra-observer agreements except for left ventricular segments 16-22. Right ventricular FS values showed correlations between 0.375 and 0.575, with good inter-observer agreements. There were significant differences in the mean FS values in the basal segment (segments 1-5) of the left ventricle between 18 and 21+6 and 28-31+6 weeks of gestation (p<0.05), whereas there were significant differences in all mean FS values in the right ventricle between both gestational ages (p<0.05).

Conclusions: These results suggest that the reproducibility of the 24-segment FS of the fetal heart using HQ is fair. However, there may be significant differences in FS values with advancing gestational age, especially for the right ventricle.