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Objective: velocity vector imaging (velocity vector imaging, VVI) trimester fetal umbilical cord around the neck left and right ventricular systolic and diastolic function, and analysis of the fetal left and right ventricular long axis of the characteristics of each segment movement, as well as exploring VVI technology in the evaluation of fetal cardiac function value. Methods: An object of study: the experimental group for 35 to 40 weeks of pregnancy, the diagnosis of fetal ultrasound system cord around the neck of the fetus, the umbilical artery S / D lt; 3.0 of group A, a total of 20 cases, the average gestational age 36.9 ± 1.4 weeks, pregnant women aged 24 to 36 years old, mean age 29.1 ± 3.9 years; umbilical artery S / D ≥ 3.0 (group B), a total of 15 cases, with an average gestational age of 36.7 ± 1.5 weeks, pregnant women aged 22 to 34 years old, average age 27.2 ± 3.2 years old. The control group was 35 to 40 weeks' gestation fetal umbilical cord around the neck of 20 patients, with an average gestational age of 36.3 ± 1.5 weeks, pregnant women aged 23 to 35 years old, average age 28.0 ± 3.5 years. Fetus are singleton pregnancies are unintended and external structural malformations and intrauterine growth retardation and fetal system ultrasonography and fetal ultrasound echocardiography diagnosis. The above pregnant women are healthy, without diabetes, hypertension, cardiovascular disease and other chronic diseases of the liver and kidney, indomethacin and other non-steroidal anti-inflammatory medication history. 2 Instrumentation: Simens ACUSON Sequoia 512 color Doppler ultrasonography, using 4V1C probe frequency of 2.25 to 4.25MHz, the instrument has a the VVI quantitative analysis software, the simultaneous quantitative measurement of myocardial velocities, strain, strain rate and analysis. 3 image storage: all pregnant women in a calm state for three consecutive cardiac cycles of the standard four-chamber view of the fetal and keep the endocardial border clear, dynamic storage pending offline analysis. 4 image analysis and parameter measurement into the the VVI operating interface, according to M ultra-curve as a reference standard to determine systolic and diastolic, end-diastolic single image, respectively, along the left and right ventricular endocardial border hand access point and reference biomarkers in the apex, click run, the system will automatically track the endocardial edge, dynamic VVI map and speed, strain and strain rate curve. Into strain rate interface, the sampling point at the midpoint of each myocardial segments, respectively left and right ventricular longitudinal speed of 6 segments, strain and strain rate curve, measurement of left and right ventricular peak systolic longitudinal six segments speed (Vs), peak systolic strain (Ss), peak systolic strain rate (SRs) and diastolic peak velocity (Vd) and peak diastolic strain rate (SRD). Longitudinal left ventricular systolic the 6 segments peak velocity, strain and strain rate on average, you can get the entire left ventricular systolic longitudinal velocity (global systolic longitudinal Velocity GLVs,), the overall left ventricular systolic longitudinal strain (global systolic longitudinal the strain, GLSs) and overall left ventricular systolic longitudinal strain rate (global systolic longitudinal strain rate, GLSRs); longitudinal left ventricular diastolic the 6 segments peak velocity and strain rate, respectively, on average, can be obtained by left ventricular diastolic overall longitudinal speed (global diastolic longitudinal velocity, GLVd) and left ventricular diastolic overall longitudinal strain rate (global diastolic longitudinal strain rate, GLSRd). Similarly, the right ventricular systolic longitudinal 6 segments peak velocity, strain and strain rate on average to get the right ventricular systolic the overall longitudinal velocity (global systolic longitudinal Velocity GLVs,), right ventricular systolic the whole longitudinal strain (global systolic average longitudinal strain, GLSs) and right ventricular systolic overall longitudinal strain rate (global systolic longitudinal strain rate, GLSRs); longitudinal right ventricular diastolic peak velocity and strain rate of 6 segments, you can get right ventricular diastolic overall longitudinal velocity (global diastolic longitudinal strain, GLVd) and right ventricular diastolic overall longitudinal strain rate (global diastolic longitudinal Strain Rate, GLSRd). Results: 1 fetal left and right ventricular long axis of each segment motion characteristics fetal left and right ventricular wall and interventricular septum systolic and diastolic peak velocity from the basal segment to the apical segment gradually decreases, and the difference was statistically significant (p < ; 0.05); systolic, diastolic peak strain rate and peak systolic strain in the basal segments of the middle section was no significant difference (p gt; 0.05) and apical segments. Between three groups reflect the comparison of left ventricular systolic function parameters cord around the neck Group B the fetus left ventricular GLSs in GLSRs were significantly less than the A group and the control group, the difference was statistically significant (p lt; 0.05); cord around the neck of group A the fetus left ventricular GLSs GLSRs compared with the control group, the difference was not statistically significant (p gt; 0.05) Among the three groups the left ventricular GLVs compared, the difference was not statistically significant (p gt; 0.05). 3 three groups reflect the comparison of umbilical cord around the neck of the left ventricular diastolic function parameters in group B fetus left ventricular GLSRd in significantly less than the A group and the control group, the difference was statistically significant (p lt; 0.05); cord around the neck A group of fetal left ventricular GLSRd compared with the control group, the difference was not statistically significant (p gt; 0.05). Among the three groups the left ventricular GLVd compared, the difference was not statistically significant (p gt; 0.05). 4 three groups Compare cord around the neck in group B fetal right ventricular GLSs and the GLSRs between reflected right ventricular systolic function parameters were significantly less than the A group and the control group, the difference was statistically significant (p lt; 0.05); cord around the neck of group A the fetus the right ventricular GLSs and GLSRs compared with the control group, the difference was not statistically significant (p gt; 0.05). The three groups the right ventricular GLVs compared, the difference was not statistically significant (p gt; 0.05) Compare cord around the neck Group B fetal right ventricular GLSRd 5 three groups reflect right ventricular diastolic function parameters significantly less than the A group and the control group, the difference was statistically significant (p lt; 0.05); cord around the neck A group of fetal right ventricular GLSRd compared with the control group, the difference was not statistically significant (p gt; 0.05). The three groups the right ventricular GLVd compared, the difference was not statistically significant (p gt; 0.05). Conclusion: The fetal left and right ventricular long axis of the characteristics of each segment movement: from the basal segment to the apical segment myocardial velocities gradually reduce the strain and strain rate remains constant. 2 umbilical artery S / D ≥ 3.0 cord around the neck of the fetus left, right ventricular systolic overall longitudinal strain, strain rate and diastolic overall longitudinal strain rate than the S / D lt; 3.0 cord around the neck of the group and the normal control group reduce prompted umbilical artery S / D ≥ 3.0 the fetal cord around the neck of the left and right ventricular systolic and diastolic dysfunction. 3 velocity vector imaging is a new analysis of the cardiac structural mechanics and quantitative evaluation of myocardial function, independent of beam angle, fetal position and fetal heart rate, non-invasive quantitative detection of fetal cardiac function for the clinical evaluation of the fetal heart provides another valuable method.
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