Fetal myocardial mechanics

Abstract

Maturational and structural differences and external constraint on the fetal myocardium give rise to observed differences in cardiac function between fetal and postnatal life. Traditional M-Mode, gray-scale 2-dimensional, and Doppler blood flow techniques give indirect insight into myocardial function and its interactions with the vasculature. Over the past decade, several new indices derived from echocardiographic Doppler and tissue Doppler measurements have been proposed as noninvasive measures of systolic and diastolic dysfunction. One of the newest technologies enlisted in the evaluation of fetal and postnatal myocardial function has been measurement of myocardial strain and strain rate using algorithms to track individual regional myocardial mechanics. Tissue Doppler, 2D speckle, tissue and feature tracking are among the newer noninvasive ultrasound-based techniques which allow direct noninvasive assessment of myocardial motion and mechanics and may have a role in helping to unravel the intricacies of developmental maturational changes in myocardial mechanics. Additionally, understanding the strengths and limitations of these techniques may assist in future research to determine their role in clinical practice.