OP10.03: Fetal TAPSE Index (FTI): a Novel Fetal Heart Function Index in Pathological Cases

Various tests are applied to evaluate fetal heart function in cases of cardiac and extra-cardiac disorders: MPI and SF in the left ventricle and f-TAPSE to right heart assessment. We devised an index adjusting f-TAPSE for the size of the heart by calibrating the measure to heart length, thus obtaining a sensitive index in cases where heart dimensions deviate from normal for GA or EFW. We aimed to evaluate the f-TAPSE index (FTI) in pathological cases of CHD and extracardiac disorders such as TTTS, diaphragmatic hernia, placental tumours, fetal anemia, and others. F-TAPSE was obtained for 132 fetuses with known cardiac structural defects or dysfunction presenting for follow-up. CRL up to 14 weeks and EFW thereafter, were recorded. Fetal heart length was measured in the 4CV plane on the pericardium, from the base to the apex, at the front or rear apex. The f-TAPSE result was divided by heart length, and then plotted against FTI gestational age scatterplots created from 433 normal fetuses. 132 cases were examined, GA range 11-40 weeks. Deviation from the interquartile range calculated in normal fetuses (0.15-0.26) was observed in pathological cases that showed impaired heart function. In some cases, the index was extremely low, although conventional f-TAPSE measurement was borderline or even within normal range. During the study, 2 very rare cases were diagnosed with only partial myocardial contraction. Case 1 had a pathological lesion of the left ventricle with aneurysm; Case 2 had dysfunctional contraction in a portion of the right ventricle. In both cases, cardiac function and FTI were monitored throughout pregnancy. Deviation from normal range reflected the cardiac dysfunction, commensurate with the pathology, and added to our evaluation. FTI is a sensitive indicator that shows a deviation from the norm in pathological cases, by incorporating heart size. This adjustment gives this index an advantage over conventional f-TAPSE. We suggest that fetal TAPSE Index be used to evaluate fetal heart function in normal and pathological cases. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.