{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T12:07:20Z","timestamp":1784203640120,"version":"3.55.0"},"reference-count":52,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2026,2,9]],"date-time":"2026-02-09T00:00:00Z","timestamp":1770595200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Echocardiography currently represents the gold standard for the anatomical and functional assessment of the fetal heart by experienced operators. FetalHQ (VolusonTM) provides a semi-automated speckle-tracking analysis of the fetal heart with promising results for the reliable assessment of cardiac remodeling, specifically of size, shape, and contractility. Methods: We conducted a retrospective study comparing 108 controls, 119 obesity (BMI \u2265 30), 69 pre-pregnancy diabetes mellitus (DM), 41 gestational diabetes mellitus (GDM), and 37 early fetal growth restriction (FGR) cases (19+0\u201322+6 weeks). FetalHQ was utilized during midtrimester echocardiographic exams to evaluate fetal myocardial thickness and left ventricular mass. Results: Myocardial thickness was increased in DM (median 0.21 [IQR 0.17\u20130.23] cm) vs. controls (0.17 [0.15\u20130.21] cm; p &lt; 0.01) and reduced in FGR (0.13 [0.11\u20130.18] cm; p &lt; 0.01). Left ventricular mass increased in obesity (0.98 [0.62\u20131.19] g) and DM (1.12 [0.94\u20131.17] g) vs. controls (0.73 [0.56\u20130.97] g; both p &lt; 0.01). Conclusions: Fetal cardiac remodeling, especially myocardial thickness and left ventricular mass adaptations, is detectable in fetuses from high-risk pregnancies starting from the second trimester. Advanced speckle-tracking techniques, such as fetalHQ, provide valuable early risk stratification and may support the need for systematic fetal cardiac screening and monitoring during gestation in selected groups of patients.<\/jats:p>","DOI":"10.3390\/jcm15041352","type":"journal-article","created":{"date-parts":[[2026,2,9]],"date-time":"2026-02-09T08:15:54Z","timestamp":1770624954000},"page":"1352","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Midtrimester Evaluation of Fetal Heart with Fetal Heart Quantification (FetalHQ) Related to Maternal Pathology"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9427-1391","authenticated-orcid":false,"given":"Stefano Raffaele","family":"Giannubilo","sequence":"first","affiliation":[{"name":"Department of Clinical Sciences, Obstetrics and Gynecology Section, Universit\u00e0 Politecnica Delle Marche, 60123 Ancona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camilla","family":"Grelloni","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences, Obstetrics and Gynecology Section, Universit\u00e0 Politecnica Delle Marche, 60123 Ancona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Cecchi","sequence":"additional","affiliation":[{"name":"Centro Unico Regionale SODS, Diagnosi Prenatale di II Livello, 60025 Loreto, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisa","family":"Carboni","sequence":"additional","affiliation":[{"name":"Centro Unico Regionale SODS, Diagnosi Prenatale di II Livello, 60025 Loreto, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe Maria","family":"Maruotti","sequence":"additional","affiliation":[{"name":"Gynecology and Obstetrics Unit, Department of Public Health, University of Naples Federico II, 80138 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Mannolini","sequence":"additional","affiliation":[{"name":"Gynecology and Obstetrics Unit, Department of Public Health, University of Naples Federico II, 80138 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessia Maria","family":"Merone","sequence":"additional","affiliation":[{"name":"Gynecology and Obstetrics Unit, Department of Public Health, University of Naples Federico II, 80138 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Terrone","sequence":"additional","affiliation":[{"name":"Gynecology and Obstetrics Unit, Department of Public Health, University of Naples Federico II, 80138 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8037-4947","authenticated-orcid":false,"given":"Andrea","family":"Ciavattini","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences, Obstetrics and Gynecology Section, Universit\u00e0 Politecnica Delle Marche, 60123 Ancona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,2,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1159\/000501906","article-title":"The Transitional Heart: From Early Embryonic and Fetal Development to Neonatal Life","volume":"47","author":"Tan","year":"2019","journal-title":"Fetal Diagn. 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