Myocardial strain abnormalities in fetuses with pulmonary atresia and intact ventricular septum

ABSTRACT Objectives Global and regional myocardial deformation have not been well described in fetuses with pulmonary atresia and intact ventricular septum (PA/IVS). Speckle‐tracking echocardiography (STE), an angle‐independent technique for assessing global and regional strain, may be a more sensitive way of determining ventricular systolic dysfunction compared with traditional 2D echocardiography. The aim of this study was to assess myocardial deformation in fetuses with PA/IVS compared with control fetuses and to determine if, in fetuses with PA/IVS, strain differs between those with and those without right ventricle‐dependent coronary circulation (RVDCC). Methods This was a retrospective analysis of fetuses with PA/IVS examined at two medical centers between June 2005 and October 2017. Left ventricular (LV) and right ventricular (RV) regional and global longitudinal strain (GLS) and strain rate were obtained using STE, and comparisons were made between fetuses with PA/IVS and gestational age (GA)‐matched controls. Postnatal outcome was assessed, including the presence of RVDCC. Results Fifty‐seven fetuses with PA/IVS and 57 controls were analyzed at a mean GA of 26.5 ± 5 weeks. LV‐GLS was significantly decreased in fetuses with PA/IVS compared with controls (−17.4 ± 1.7% vs −23.7 ± 2.0%, P