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Article: Longitudinal Surveillance of Fetal Heart Failure Using Speckle Tracking Analysis.

Murlewska, Julia / Sylwestrzak, Oskar / Respondek-Liberska, Maria / Sklansky, Mark / Devore, Greggory

2022 Volume 11, Issue 23

Abstract: Long-term monitoring of a fetus with heart failure is an undeniable challenge for prenatal cardiology. Echocardiography is constrained by many fetal and maternal factors, and it is difficult to maintain the reproducibility of the measured and analyzed ... ...

Abstract	Long-term monitoring of a fetus with heart failure is an undeniable challenge for prenatal cardiology. Echocardiography is constrained by many fetal and maternal factors, and it is difficult to maintain the reproducibility of the measured and analyzed parameters. In our study, we presented the possibilities of using modern speckle tracking technology in combination with standard echocardiography parameters that may be insufficient or less sensitive in the context of monitoring life-threatening fetal conditions. Our analysis shows the superiority of the parameters used to assess fetal cardiac architecture, such as the GSI Global sphericity Index, and fetal cardiac function, such as the FAC fractional area change and the EF ejection fraction, which temporal change may indicate a worsening condition of the fetus with heart failure. The significant increase in the parameters of fetal heart size in speckle tracking allows for an improved echocardiographic diagnosis and monitoring of the fetus with heart failure and the prognostic conclusions about the clinical condition after birth. Significant decreases in FAC for the left and right ventricles and EF for the left ventricle may indicate an unfavourable prognosis for the monitored fetus due to heart failure.
Language	English
Publishing date	2022-11-30
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662592-1
ISSN	2077-0383
ISSN	2077-0383
DOI	10.3390/jcm11237102
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Article: Three-dimensional and four-dimensional fetal echocardiography: a new frontier.

Devore, Greggory R

Current opinion in pediatrics

2005 Volume 17, Issue 5, Page(s) 592–604

Abstract: Purpose of review: One of the difficulties of conventional two-dimensional cardiac imaging is the inability to examine fetal cardiac anatomy from multiple angle planes. Three-dimensional and four-dimensional ultrasound allows the fetal examiner to more ... ...

Abstract	Purpose of review: One of the difficulties of conventional two-dimensional cardiac imaging is the inability to examine fetal cardiac anatomy from multiple angle planes. Three-dimensional and four-dimensional ultrasound allows the fetal examiner to more accurately accomplish this task. Currently, multiple disciplines may be involved in the examination of the fetal heart (pediatric cardiologists, obstetricians, maternal-fetal medicine specialists, and radiologists). The three-dimensional and four-dimensional imaging equipment used by these specialty physicians varies greatly. The purpose of this communication is to review techniques using three-dimensional and four-dimensional imaging that the pediatric cardiologist may not be exposed to in the clinical environment, however, in consulting with colleagues needs to have an understanding of these imaging modalities. Recent findings: The reconstruction of cardiac structures using this technology allows the examiner to view cardiac anatomy in a manner that was limited by previous two-dimensional imaging. Volume datasets are obtained in the three-dimensional static mode (no cardiac motion) or using four-dimensional - the three-dimensional heart is observed contracting during one or multiple cardiac cycles. Therefore, the fourth dimension is time. Using either three-dimensional or four-dimensional technology datasets are acquired, followed by image reconstruction. The image reconstruction enables the examiner to evaluate a two-dimensional image using multiple views, evaluate intracardiac anatomy at different depth planes, and recreate casts of blood flow of the chambers and great vessels. Summary: This new technology has enhanced the ability of the examiner to identify normal and complex fetal heart anatomy during the early second to the late third trimesters of pregnancy.
MeSH term(s)	Echocardiography, Four-Dimensional/methods ; Echocardiography, Three-Dimensional/methods ; Fetal Heart/diagnostic imaging ; Humans ; Risk Assessment ; Ultrasonography, Prenatal/methods
Language	English
Publishing date	2005-07-26
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	1049374-8
ISSN	1531-698X ; 1040-8703
ISSN (online)	1531-698X
ISSN	1040-8703
DOI	10.1097/01.mop.0000172815.41519.a4
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Zs.A 3049: Show issues

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Article: Feasibility of 4D-Spatio Temporal Image Correlation (STIC) in the Comprehensive Assessment of the Fetal Heart Using FetalHQ

Nogué, Laura / Gómez, Olga / Izquierdo, Nora / Mula, Cristina / Masoller, Narcís / Martínez, Josep M / Gratacós, Eduard / Devore, Greggory / Crispi, Fàtima / Bennasar, Mar

Journal of clinical medicine

2022 Volume 11, Issue 5

Abstract: Fetal Heart Quantification (FetalHQ®) is a novel speckle tracking software that permits the study of global and regional ventricular shape and function from a 2D four-chamber-view loop. The 4D-Spatio Temporal Image Correlation (STIC) modality enables the ...

Abstract	Fetal Heart Quantification (FetalHQ®) is a novel speckle tracking software that permits the study of global and regional ventricular shape and function from a 2D four-chamber-view loop. The 4D-Spatio Temporal Image Correlation (STIC) modality enables the offline analysis of optimized and perfectly aligned cardiac planes. We aimed to evaluate the feasibility and reproducibility of 4D-STIC speckle tracking echocardiography (STE) using FetalHQ® and to compare it to 2D STE. We conducted a prospective study including 31 low-risk singleton pregnancies between 20 and 40 weeks of gestation. Four-chamber view volumes and 2D clips were acquired with an apex pointing at 45° and with a frame rate higher than 60 Hz. Morphometric and functional echocardiography was performed by FetalHQ®. Intra- and interobserver reproducibility were evaluated by the intraclass correlation coefficient (ICC). Our results showed excellent reproducibility (ICC > 0.900) for morphometric evaluation (biventricular area, longitudinal and transverse diameters). Reproducibility was also good (ICC > 0.800) for functional evaluation (biventricular strain, Fractional Area Change, left ventricle volumes, ejection fraction and cardiac output). On the contrary, the study of the sphericity index and shortening fraction of the different ventricular segments showed lower reproducibility (ICC < 0.800). To conclude, 4D-STIC is feasible, reproducible and comparable to 2D echocardiography for the assessment of cardiac morphometry and function.
Language	English
Publishing date	2022-03-04
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662592-1
ISSN	2077-0383
ISSN	2077-0383
DOI	10.3390/jcm11051414
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Article ; Online: Fetal cardiac rhabdomyomas treated with maternal sirolimus.

Pluym, Ilina D / Sklansky, Mark / Wu, Joyce Y / Afshar, Yalda / Holliman, Kerry / Devore, Greggory R / Walden, Ayanna / Platt, Lawrence D / Krakow, Deborah

Prenatal diagnosis

2020 Volume 40, Issue 3, Page(s) 358–364

Abstract: Objective: To review the pathophysiology of rhabdomyomas and the emerging option of prenatal treatment of fetal cardiac rhabdomyomas.: Methods: We present a case of fetal rhabdomyomas causing significant hemodynamic compromise that received in utero ... ...

Abstract	Objective: To review the pathophysiology of rhabdomyomas and the emerging option of prenatal treatment of fetal cardiac rhabdomyomas. Methods: We present a case of fetal rhabdomyomas causing significant hemodynamic compromise that received in utero treatment of maternal sirolimus. Genetic amniocentesis confirmed a TSC2 mutation. A treatment program was initiated with a 10-mg loading dose titrated to a goal maternal trough of 10 to 15 ng/dL. In order to follow fetal cardiac function, a sophisticated method of speckle tracking echocardiography was used before and after treatment. Obstetric ultrasound was used to monitor fetal growth, and clinical surveillance, echocardiography, and brain MRI were used to monitor postnatal growth and development through 6 months of neonatal life. Results: Sirolimus was initiated from 28 to 36 weeks of gestation with improvement of cardiac status. During this period, intrauterine growth restriction developed. Postnatally, the infant has had stable rhabdomyomas and cardiac function without reinitiating sirolimus. Brain MRI demonstrated scattered cortical tubers and subependymal nodules, and the infant has not had seizure-like activity. At 6 months of age, the infant has achieved appropriate developmental milestones. Conclusion: In counseling cases of prenatal onset large obstructing rhabdomyomas and cardiac compromise, in utero sirolimus treatment can be considered.
MeSH term(s)	Adult ; Amniocentesis ; Echocardiography ; Female ; Genetic Testing ; Gestational Age ; Heart Neoplasms/drug therapy ; Heart Neoplasms/embryology ; Heart Neoplasms/genetics ; Humans ; Mutation ; Pregnancy ; Prenatal Diagnosis ; Rhabdomyoma/drug therapy ; Rhabdomyoma/embryology ; Rhabdomyoma/genetics ; Sirolimus/administration & dosage ; TOR Serine-Threonine Kinases/antagonists & inhibitors ; Treatment Outcome ; Tuberous Sclerosis Complex 2 Protein/genetics
Chemical Substances	TSC2 protein, human ; Tuberous Sclerosis Complex 2 Protein ; MTOR protein, human (EC 2.7.1.1) ; TOR Serine-Threonine Kinases (EC 2.7.11.1) ; Sirolimus (W36ZG6FT64)
Language	English
Publishing date	2020-01-02
Publishing country	England
Document type	Case Reports ; Journal Article
ZDB-ID	82031-3
ISSN	1097-0223 ; 0197-3851
ISSN (online)	1097-0223
ISSN	0197-3851
DOI	10.1002/pd.5613
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Zs.A 1625: Show issues

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Jg. 1995 - 2021: Lesesall (1.OG)
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Article: Tomographic ultrasound imaging of the fetal heart: a new technique for identifying normal and abnormal cardiac anatomy.

Devore, Greggory R / Polanko, Bardo

Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine

2005 Volume 24, Issue 12, Page(s) 1685–1696

Abstract: Objective: In 2003 and 2004, the American College of Radiology, the American Institute of Ultrasound in Medicine, and the American College of Obstetricians and Gynecologists published guidelines for the standard ultrasound examination of the fetus. Each ...

Abstract	Objective: In 2003 and 2004, the American College of Radiology, the American Institute of Ultrasound in Medicine, and the American College of Obstetricians and Gynecologists published guidelines for the standard ultrasound examination of the fetus. Each group recommended that the outflow tracts of the fetal heart be examined if technically feasible. One method to accomplish this task is to perform a free-hand sweep of the transducer beam directed in a transverse plane from the 4-chamber view to the fetal neck. One problem with this approach is that the examiner may not direct the beam transversely and, therefore, may not accurately identify the outflow tract anatomy. Methods: A new technology, tomographic ultrasound imaging (TUI), allows the examiner to obtain a volume data set that simultaneously displays multiple images at specific distances from the 4-chamber view. This study examined TUI technology for identifying normal and abnormal fetal cardiac anatomy with the use of either static or spatiotemporal image correlation volume data sets. Results: The 4 views used in the screening examination of the outflow tracts of the fetal heart (4-chamber, 5-chamber, 3-vessel, and tracheal views) could be identified with the use of TUI technology in fetuses between 13 and 40 weeks' gestation. Examples of fetuses with abnormal cardiac anatomy of the outflow tracts (tetralogy of Fallot, transposition of the great vessels, and pulmonary stenosis) all showed abnormal anatomy on TUI. Conclusions: Tomographic ultrasound imaging technology enables the fetal examiner to evaluate the 4-chamber view and the outflow tracts in a systematic manner to identify normal and abnormal cardiac anatomy.
MeSH term(s)	Female ; Heart Defects, Congenital/diagnostic imaging ; Humans ; Image Enhancement/methods ; Imaging, Three-Dimensional/methods ; Pregnancy ; Reproducibility of Results ; Sensitivity and Specificity ; Technology Assessment, Biomedical ; Tomography/methods ; Tomography/trends ; Ultrasonography, Prenatal/methods ; Ultrasonography, Prenatal/trends
Language	English
Publishing date	2005-09-08
Publishing country	England
Document type	Clinical Trial ; Journal Article
ZDB-ID	604829-8
ISSN	1550-9613 ; 0278-4297
ISSN (online)	1550-9613
ISSN	0278-4297
DOI	10.7863/jum.2005.24.12.1685
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Zs.A 1793: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
Zs.MO 495: Show issues

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Article: Improving cleft palate/cleft lip antenatal diagnosis by 3-dimensional sonography: the "flipped face" view.

Platt, Lawrence D / Devore, Greggory R / Pretorius, Dolores H

Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine

2005 Volume 25, Issue 11, Page(s) 1423–1430

Abstract: Objective: Three-dimensional sonography has enhanced the diagnosis of congenital anomalies in the early stages of pregnancy. Both cleft lip and palate remain a diagnostic challenge for the sonographer because of the variable size of the defects as well ... ...

Abstract	Objective: Three-dimensional sonography has enhanced the diagnosis of congenital anomalies in the early stages of pregnancy. Both cleft lip and palate remain a diagnostic challenge for the sonographer because of the variable size of the defects as well as their location. Recently, a technique described by Campbell et al (Ultrasound Obstet Gynecol 2003; 22:552-554, 2005; 25:12-18) demonstrated an improved method called the "reverse face" view, which appears to assist in the diagnosis of clefts involving the palate. Methods: The fetal face was initially examined with the fetus in the supine position. Using 3-dimensional sonography, a static volume was acquired. Following acquisition of the volume, it was rotated 90 degrees so that the cut plane was directed in a plane from the chin to the nose. The volume cut plane was then scrolled from the chin to the nose to examine in sequential order the lower lip, mandible, and alveolar ridge; tongue; upper lip, maxilla, and alveolar ridge; and hard and soft palates. Results: This approach identified the full length and width of the structures of the mouth and palates and allows the examiner to identify normal anatomy as well as clefts of the hard and soft palates. Conclusions: The fetal hard and soft palates of the mouth can be accessed using a new technique, which we call the "flipped face" maneuver, when an adequate volume of the face can be obtained.
MeSH term(s)	Cleft Lip/diagnostic imaging ; Cleft Palate/diagnostic imaging ; Female ; Fetal Diseases/diagnostic imaging ; Humans ; Imaging, Three-Dimensional/methods ; Maxillofacial Development ; Pregnancy ; Ultrasonography, Prenatal/methods
Language	English
Publishing date	2005-09-08
Publishing country	England
Document type	Evaluation Studies ; Journal Article
ZDB-ID	604829-8
ISSN	1550-9613 ; 0278-4297
ISSN (online)	1550-9613
ISSN	0278-4297
DOI	10.7863/jum.2006.25.11.1423
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Zs.A 1793: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
Zs.MO 495: Show issues

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Article: Four-dimensional fetal echocardiography with spatiotemporal image correlation (STIC): a systematic study of standard cardiac views assessed by different observers.

Gonçalves, Luís F / Espinoza, Jimmy / Romero, Roberto / Lee, Wesley / Treadwell, Marjorie C / Huang, Raywin / Devore, Greggory / Chaiworapongsa, Tinnakorn / Schoen, Mary Lou / Beyer, Betsy

The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians

2005 Volume 17, Issue 5, Page(s) 323–331

Abstract: Objective: To test the agreement between observers and reproducibility of a technique to display standard cardiac views of the left and right ventricular outflow tracts from four-dimensional volume datasets acquired with Spatiotemporal Image Correlation ...

Abstract	Objective: To test the agreement between observers and reproducibility of a technique to display standard cardiac views of the left and right ventricular outflow tracts from four-dimensional volume datasets acquired with Spatiotemporal Image Correlation (STIC). Methods: A technique was developed to obtain dynamic multiplanar images of the left ventricular outflow tract (LVOT) and right ventricular outflow tract (RVOT) from volume datasets acquired with STIC. Volume datasets were acquired from fetuses with normal cardiac anatomy. Twenty volume datasets of satisfactory quality were pre-selected by one investigator. The data was randomly assigned for a blinded review by two independent observers with previous experience in fetal echocardiography. Only one volume dataset was used for each fetus. After a training session, the observers obtained standardized cardiac views of the LVOT and RVOT, which were scored on a scale of 1 to 5, based on diagnostic value and image quality (1=unacceptable, 2=marginal, 3=acceptable, 4=good, and 5=excellent). Median scores and interquartile range, as well as inter- and intraobserver agreement were calculated for each view. Results: The mean menstrual age at the time of volume acquisition was 25.5+/-4.5 weeks. Median scores (interquartile range) for LVOT images, obtained by the first and second observers, were 3.5 (2.25-5.00) and 4 (3.00-5.00), respectively. The median scores (interquartile range) for RVOT images obtained by the first and second observers were 3 (3.00-5.00) and 3 (2.00-4.00), respectively. The interobserver intraclass correlation coefficient for the LVOT was 0.693 (95% CI 0.380-0.822), and 0.696 (95% CI 0.382-0.866) for the RVOT. For the intraobserver agreement analysis, observer 1 gave higher scores to the LVOT the second time the volumes were analyzed [LVOT: 3.50 (2.25-5.00) vs. 5.00 (4.00-5.00, p=0.008)]. Conclusion: STIC can be reproducibly used to evaluate fetal cardiac outflow tracts by independent examiners. Slightly better image quality rating scores during the intraobserver variability trial suggests the presence of a learning curve for the manipulation and analysis of volume data obtained by STIC.
MeSH term(s)	Double-Blind Method ; Echocardiography, Four-Dimensional ; Female ; Fetal Heart/diagnostic imaging ; Heart Defects, Congenital/diagnostic imaging ; Humans ; Image Interpretation, Computer-Assisted ; Observer Variation ; Pregnancy ; Pregnancy Trimester, Second ; Reproducibility of Results ; Ultrasonography, Prenatal
Language	English
Publishing date	2005-05
Publishing country	England
Document type	Journal Article ; Randomized Controlled Trial
ZDB-ID	2077261-0
ISSN	1476-4954 ; 1476-7058 ; 1057-0802
ISSN (online)	1476-4954
ISSN	1476-7058 ; 1057-0802
DOI	10.1080/14767050500127765
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Zs.A 3510: Show issues

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Article: Three- and 4-dimensional ultrasound in obstetrics and gynecology: proceedings of the American Institute of Ultrasound in Medicine Consensus Conference.

Benacerraf, Beryl R / Benson, Carol B / Abuhamad, Alfred Z / Copel, Joshua A / Abramowicz, Jacques S / Devore, Greggory R / Doubilet, Peter M / Lee, Wesley / Lev-Toaff, Anna S / Merz, Eberhard / Nelson, Thomas R / O'Neill, Mary Jane / Parsons, Anna K / Platt, Lawrence D / Pretorius, Dolores H / Timor-Tritsch, Ilan E

Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine

2005 Volume 24, Issue 12, Page(s) 1587–1597

Abstract: The American Institute of Ultrasound in Medicine convened a panel of physicians and scientists with interest and expertise in 3-dimensional (3D) ultrasound in obstetrics and gynecology to discuss the current diagnostic benefits and technical limitations ... ...

Abstract	The American Institute of Ultrasound in Medicine convened a panel of physicians and scientists with interest and expertise in 3-dimensional (3D) ultrasound in obstetrics and gynecology to discuss the current diagnostic benefits and technical limitations in obstetrics and gynecology and consider the utility and role of this type of imaging in clinical practice now and in the future. This conference was held in Orlando, Florida, June 16 and 17, 2005. Discussions considered state-of-the-art applications of 3D ultrasound, specific clinical situations in which it has been found to be helpful, the role of 3D volume acquisition for improving diagnostic efficiency and patient throughput, and recommendations for future investigations related to the utility of volume sonography in obstetrics and gynecology.
MeSH term(s)	Female ; Genital Diseases, Female/diagnostic imaging ; Gynecology/methods ; Gynecology/trends ; Humans ; Imaging, Three-Dimensional/methods ; Imaging, Three-Dimensional/trends ; Obstetrics/methods ; Obstetrics/trends ; Practice Guidelines as Topic ; Practice Patterns, Physicians'/trends ; Pregnancy ; Pregnancy Complications/diagnostic imaging ; Societies, Medical/organization & administration ; Ultrasonography/methods ; Ultrasonography/trends ; Ultrasonography, Prenatal/methods ; Ultrasonography, Prenatal/trends ; United States
Language	English
Publishing date	2005-09-08
Publishing country	England
Document type	Consensus Development Conference ; Journal Article
ZDB-ID	604829-8
ISSN	1550-9613 ; 0278-4297
ISSN (online)	1550-9613
ISSN	0278-4297
DOI	10.7863/jum.2005.24.12.1587
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Zs.MO 495: Show issues

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