EP09.65: Preliminary study of cardiac morphology and function in fetuses with tetralogy of Fallot using fetal HQ

To evaluate fetal heart shape and function in fetuses with tetralogy of Fallot (TOF) by fetal HQ. Fifty-two TOF fetuses and 200 normal fetuses matched with GA were retrospectively evaluated. AO, PA, main PA diameters, Z scores, global spherical index (GSI) area and length of the RV and LV and their ratios were obtained. Measurements of LV and RV function: including ejection fraction (EF), fraction area change rate (FAC), TAPSE, LV and RV global longitudinal strain (GLS), and LV and RV end-diastolic diameter (ED), spherical index (SI), and fractional shortening rate (FS) of 24-segments were compared and analysed and the differences between TOF fetuses and normal fetuses were investigated. Compared with normal group, there were significant differences in 4CV end diastolic length, area, GSI, LV area, LV length, LVEF, LVFAC and LVGLS in TOF group (P<0.05). There was significant difference in ED between LV 15-24 segment and RV 1-21 segment (P<0.05). There was statistically significant difference in SI between LV 1-17 segments, 20-24 segments and all segments of RV(P<0.05). The differences in FS were statistically significant (P<0.05) when comparing all LV segments of and 1-2 RV segments, and the remaining parameters were not statistically significant (P>0.05). The LV and RV GLS of TOF fetuses were positively correlated with PA/AO, PV Z-score and MPV Z-score. The optimal critical values of GSI, LVEF, and LVFAC in the diagnosis of fetal TOF were 1.19, 59.05%, and 44.4%, respectively. The sensitivity of diagnosis of TOF was 78.0%, 75%, and 80%, respectively. The specificity was 88%, 88%, and 83%, respectively. The area under ROC curve was 0.89, 0.88, and 0.89, respectively. Fetal HQ can be used for the quantitative analysis of cardiac morphology and function in fetuses with TOF, providing a new method for the diagnosis of TOF fetuses.