Assessment of fetal left ventricular function in pregnancies with Anti-Ro/SSA or Anti-La/SSB antibodies using velocity vector imaging

Intrauterine exposure to anti SSA/Ro and anti SSB/La antibodies has been associated with the development of fetal congenital heart block and, in severe cases, fetal demise. Therefore, early and accurate assessment of fetal cardiac function is of critical importance. Velocity vector imaging (VVI) is an emerging technique capable of providing a detailed assessment of cardiac function. This study aimed to assess and compare left ventricular myocardial function in fetuses of pregnant women with and without anti-Ro/SSA or anti-La/SSB antibodies, and to explore the correlation between global myocardial function parameters and gestational age using VVI technology. A total of 90 pregnant women with anti-Ro/SSA or anti-La/SSB antibodies were enrolled as the study group, and 90 pregnant women without autoimmune antibodies were included as the control group. Participants were stratified into four subgroups based on their gestational age. Fetal left ventricular regional and global velocities, strain, strain rate, and additional myocardial parameters were measured using ultrasound-based VVI. Several regional longitudinal myocardial parameters of the fetal left ventricle were significantly lower in the study group compared to the control group (p < 0.05). Similarly, global longitudinal myocardial parameters were significantly reduced in the study group than those in the control group (p < 0.05). In both groups, the global peak velocity of fetal left ventricle increased with advancing gestational age. However, no statistically significant difference was observed between gestational age and either strain or peak strain rate (p > 0.05). VVI-derived parameters effectively reflect early alterations in myocardial mechanics in fetuses exposed to anti-Ro/SSA or anti-La/SSB antibodies. This modality enables quantitative evaluation of both regional and global myocardial motion and may assist clinicians in timely identification of myocardial dysfunction. Moreover, global VVI parameters hold potential as early indicators of myocardial impairment in this high-risk population.