Feature | Cardiovascular Ultrasound | October 30, 2018

Cardiac Ultrasound Software Streamlines Fetal Heart Exams

fetalHQ software on GE Voluson ultrasound system assesses size, shape and function of fetal heart in less than 3 minutes

Cardiac Ultrasound Software Streamlines Fetal Heart Exams

October 30, 2018 — At 18 weeks, a baby’s heart is the size of an olive and beating about 150 times per minute.[1] The structure itself is extremely complex — and with the baby in constant motion, it is always a moving target.

Evaluating the fetal heart is complicated. In fact, the initial assessment can be one of the most difficult ultrasound exams to perform, particularly for less-experienced users with minimal training.

However, these assessments are critical to detect complications or anomalies, such as congenital heart defects which affect one out of every 110 babies born around the world[2]. To complicate matters, most women are completely blindsided by the diagnosis, as 90 percent occur in pregnancies where there are no known risk factors.[3]

About three years ago, Greggory DeVore, M.D., a specialist in maternal fetal medicine in southern California, became particularly interested in fetal heart assessment when he came across a software program that was used by adult and pediatric cardiologists to examine the heart’s function using speckle tracking analysis – a technique that analyzes the motion of tissues in the heart.

He thought to himself, “I wonder if I could do that in the fetus.”

At the time, the only tools available were used to look at the anatomy and heart rate, but he wanted to also know how the heart’s shape, size and how it was contracting.

DeVore acquired the software, and that same day, he began looking at fetal hearts. He used the measurement tools for the adult heart but found that they were not helpful to the fetal evaluation. With some help, DeVore reprogrammed the software to divide the fetal heart in 24 segments – measuring the heart in ways that had never been done before.

“This was the genesis of the creativity behind using this software,” DeVore said. “From this, we made several measurements of the heart’s size, shape and contractility – or how it’s squeezing. We immediately got to work and published 13 peer-reviewed articles that described the clinical value of this software.”

This new tool – called fetalHQ – runs on GE Healthcare’s Voluson ultrasound systems and is the first tool to simultaneously examine the size, shape and function of the fetal heart.

“This is an incredible step forward in examining the fetal heart. Previously, we had various tools that looked at specific sites of the heart – but nothing that examined the entire chamber,” DeVore said. “On top of this, the heart had to be in a specific position – at 12 or six o’clock on the screen to get the proper measurements. And this all required an advanced level of diagnostic skills to learn the techniques.”

Congenital heart defects are also among the most difficult fetal abnormalities to detect. In general, low-risk detection rates are between 30 to 50 percent.[4]

For example, coarctation of the aorta is a narrowing of the aorta, the large blood vessel that branches off the heart and delivers oxygen-rich blood to the body. When this occurs, the heart must pump harder to force blood through the narrowed part of the aorta.

When examining the fetal heart’s anatomy, there are findings that are associated with coarctation, but are not always 100 percent specific for this condition. Because of this, the clinician often has to play a guessing game to decide whether coarctation is present or not. By looking at the function rather than the structure with fetalHQ, DeVore found he was able to separate these cases with almost 100 percent accuracy.

In addition, DeVore described cases where the fetus was not growing properly. Typically, this is defined as a weight less than the tenth percentile, and then divided into three groups. One of these groups entails fetuses that are between the third and tenth percentile with normal blood flow to the placenta and brain. While small, these pregnancies are typically deemed “normal” with no risk factors.

However, when DeVore examined fifty of these cases with fetalHQ, he discovered abnormal cardiac function. “This changes the whole paradigm as to how you interpret and manage these types of fetuses going forward,” DeVore said. “It allows us to ask, ‘How is the heart working?’ We’re now able to identify abnormal function, shape and size of the heart – things we couldn’t see previously.”

“Perhaps, the most incredible feature of this new tool is that we are able to collect all this information – the size, shape, and function of the fetal heart – in just two minutes and thirty seconds,” DeVore concluded.

For more information: www.gehealthcare.com

References

[1] https://www.parents.com/pregnancy/week-by-week/18/your-growing-baby-week-18/

[2] Birth Prevalence of Congenital Heart Disease Worldwide | JACC: Journal of the American College of Cardiology

[3] Why screen for heart defects?

[4]Cost-effectiveness of prenatal screening strategies for congenital heart disease

Related Content

HeartFlow Analysis Successfully Stratifies Heart Disease Patients at One Year
News | CT Angiography (CTA) | March 19, 2019
Late-breaking results confirm the HeartFlow FFRct (fractional flow reserve computed tomography) Analysis enables...
SyncVision iFR Co-registration from Philips Healthcare maps iFR pressure readings onto angiogram.

SyncVision iFR Co-registration from Philips Healthcare maps iFR pressure readings onto angiogram. Results from an international study presented at #ACC19 show that pressure readings in coronary arteries may identify locations of stenoses remaining after cardiac cath interventions.

Feature | Cardiac Imaging | March 18, 2019 | By Greg Freiherr
As many as one in four patients who undergo cath lab interventions can benefit from a technology that identifies the
Jennifer N. A. Silva, M.D., a pediatric cardiologist at Washington University School of Medicine in Saint Louis, Mo., describes “mixed reality” at ACC19 Future Hub.

Jennifer N. A. Silva, M.D., a pediatric cardiologist at Washington University School of Medicine in Saint Louis, Mo., describes “mixed reality” at ACC19 Future Hub.

Feature | Cardiac Imaging | March 17, 2019 | By Greg Freiherr
Virtual reality (VR) and its less immersive kin, augmented reality (AR), are gaining traction in some medical applica
WVU cardiology chief Partho Sengupta, M.D., describes at ACC 2019 how artificial intelligence already helps cardiologists in echocardiography.

WVU cardiology chief Partho Sengupta, M.D., describes at ACC 2019 how artificial intelligence already helps cardiologists in echocardiography. Photo by Greg Freiherr

Feature | Cardiac Imaging | March 16, 2019 | By Greg Freiherr
Machine learning is already having an enormous impact on cardiology, automatically calculating measurements in echoca
Bay Labs Announces New Data on EchoGPS, AutoEF AI Software at ACC.19
News | Cardiovascular Ultrasound | March 15, 2019
Artificial intelligence (AI) company Bay Labs announced the presentation of two studies assessing performance of the...
Podcast | Cardiac Imaging | March 15, 2019
Debate About Coronary Testing Highlights ACC Session
Siemens Healthineers Debuts Cardiovascular Edition of Somatom go.Top CT
News | Computed Tomography (CT) | March 14, 2019
Siemens Healthineers will introduce the Somatom go.Top Cardiovascular Edition, a new version of its established...
Esaote Introduces MyLab X8 Ultrasound Platform
News | Ultrasound Imaging | March 13, 2019
Esaote announced the launch of MyLab X8, a high-performance, versatile ultrasound platform to support hospitals and...
CT, Mammograms Offer Clues to Preventing Heart Problems After Cancer Treatment
News | Cardio-oncology | March 13, 2019
An imaging procedure commonly performed before starting cancer treatment can provide valuable clues about a patient's...
Podcast | Cardiac Imaging | March 12, 2019
How smart algorithms might reduce the burden of modern practice