{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T15:03:11Z","timestamp":1787670191480,"version":"build-2736575974"},"reference-count":30,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2019,3,5]],"date-time":"2019-03-05T00:00:00Z","timestamp":1551744000000},"content-version":"vor","delay-in-days":4,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100003793","name":"Hj\u00e4rt-Lungfonden","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003793","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004348","name":"Stockholms L\u00e4ns Landsting","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004348","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp;amp; Gyne"],"published-print":{"date-parts":[[2019,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Color tissue Doppler imaging (cTDI) is a promising tool for the assessment of fetal cardiac function. However, the analysis of myocardial velocity traces is cumbersome and time\u2010consuming, limiting its application in clinical practice. The aim of this study was to evaluate fetal cardiac function during the second half of pregnancy and to develop reference ranges using an automated method to analyze cTDI recordings from a cardiac four\u2010chamber view.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a cross\u2010sectional study including 201 normal singleton pregnancies between 18 and 42\u2009weeks of gestation. During fetal echocardiography, a four\u2010chamber view of the heart was visualized and cTDI was performed. Regions of interest were positioned at the level of the atrioventricular plane in the left ventricular (LV), right ventricular (RV) and septal walls of the fetal heart, to obtain myocardial velocity traces that were analyzed offline using the automated algorithm. Peak myocardial velocities during atrial contraction (Am), ventricular ejection (Sm) and rapid ventricular filling, i.e. early diastole (Em), as well as the Em\/Am ratio, mechanical cardiac time intervals and myocardial performance index (cMPI) were evaluated, and gestational age\u2010specific reference ranges were constructed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>At 18\u2009weeks of gestation, the peak myocardial velocities, presented as fitted mean with 95% CI, were: LV Am, 3.39 (3.09\u20133.70) cm\/s; LV Sm, 1.62 (1.46\u20131.79) cm\/s; LV Em, 1.95 (1.75\u20132.15) cm\/s; septal Am, 3.07 (2.80\u20133.36) cm\/s; septal Sm, 1.93 (1.81\u20132.06) cm\/s; septal Em, 2.57 (2.32\u20132.84) cm\/s; RV Am, 4.89 (4.59\u20135.20) cm\/s; RV Sm, 2.31 (2.16\u20132.46) cm\/s; and RV Em, 2.94 (2.69\u20133.21) cm\/s. At 42\u2009weeks of gestation, the peak myocardial velocities had increased to: LV Am, 4.25 (3.87\u20134.65) cm\/s; LV Sm, 3.53 (3.19\u20133.89) cm\/s; LV Em, 4.55 (4.18\u20134.94) cm\/s; septal Am, 4.49 (4.17\u20134.82) cm\/s; septal Sm, 3.36 (3.17\u20133.55) cm\/s; septal Em, 3.76 (3.51\u20134.03) cm\/s; RV Am, 6.52 (6.09\u20136.96) cm\/s; RV Sm, 4.95 (4.59\u20135.32) cm\/s; and RV Em, 5.42 (4.99\u20135.88) cm\/s. The mechanical cardiac time intervals generally remained more stable throughout the second half of pregnancy, although, with increased gestational age, there was an increase in duration of septal and RV atrial contraction, LV pre\u2010ejection and septal and RV ventricular ejection, while there was a decrease in duration of septal postejection. Regression equations used for the construction of gestational age\u2010specific reference ranges for peak myocardial velocities, Em\/Am ratios, mechanical cardiac time intervals and cMPI are presented.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Peak myocardial velocities increase with gestational age, while the mechanical time intervals remain more stable throughout the second half of pregnancy. Using an automated method to analyze cTDI\u2010derived myocardial velocity traces, it was possible to construct reference ranges, which could be used in distinguishing between normal and abnormal fetal cardiac function. Copyright \u00a9 2018 ISUOG. Published by John Wiley &amp; Sons Ltd.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.19037","type":"journal-article","created":{"date-parts":[[2018,2,27]],"date-time":"2018-02-27T03:56:38Z","timestamp":1519703798000},"page":"348-357","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Automated analysis of fetal cardiac function using color tissue Doppler imaging in second half of normal pregnancy"],"prefix":"10.1002","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4998-2450","authenticated-orcid":false,"given":"L.","family":"Herling","sequence":"first","affiliation":[{"name":"Department of Clinical Science Intervention and Technology\u00a0\u2013\u00a0CLINTEC, Karolinska Institutet  Stockholm Sweden"},{"name":"Center for Fetal Medicine, Department of Obstetrics and Gynecology Karolinska University Hospital  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Johnson","sequence":"additional","affiliation":[{"name":"Center for Fetal Medicine, Department of Obstetrics and Gynecology Karolinska University Hospital  Stockholm Sweden"},{"name":"Department of Medical Engineering, School of Technology and Health KTH Royal Institute of Technology  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.","family":"Ferm\u2010Widlund","sequence":"additional","affiliation":[{"name":"Center for Fetal Medicine, Department of Obstetrics and Gynecology Karolinska University Hospital  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F.","family":"Bergholm","sequence":"additional","affiliation":[{"name":"Department of Medical Engineering, School of Technology and Health KTH Royal Institute of Technology  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N.","family":"Elmstedt","sequence":"additional","affiliation":[{"name":"Department of Medical Engineering, School of Technology and Health KTH Royal Institute of Technology  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"Lindgren","sequence":"additional","affiliation":[{"name":"Department of Clinical Science Intervention and Technology\u00a0\u2013\u00a0CLINTEC, Karolinska Institutet  Stockholm Sweden"},{"name":"Center for Fetal Medicine, Department of Obstetrics and Gynecology Karolinska University Hospital  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.\u2010E.","family":"Sonesson","sequence":"additional","affiliation":[{"name":"Pediatric Cardiology Unit, Department of Women's and Children's Health Karolinska University Hospital  Stockholm 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