Investigations on atrial function in fetuses with signs of impaired placental function.

OBJECTIVE: Cardiac dysfunction has been shown in cases of placental insufficiency, but few reports exist on fetal atrial function. The aim of this study was to generate reference values for atrial strain and compare them to results in fetuses with signs of increased placental resistance and abnormal venous circulation.
METHODS: Using a 2D speckle-tracking technique, velocity and strain of the fetal atrial walls were investigated in 250 healthy fetuses and in 40 fetuses with abnormal umbilical Doppler. Influences of gestational age, heart rate, and frame rate on the measurements were investigated and reference curves constructed.
RESULTS: Strain and velocity were greater for the right atrial walls compared with the left, and velocity and strain rate increased with gestational age. Increased pulsatility of the ductus venosus and umbilical vein was not associated with altered right atrial function.
CONCLUSIONS: 2D speckle-tracking analysis of fetal atrial wall movement seems to be feasible. Atrial function was preserved in fetuses with placental dysfunction, even in cases of increased venous pulsatility.