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P06.05: Automation of the fetal right myocardial performance index (RMPI) to optimise repeatability

Objectives: The angle between the aortic outflow and the inter-ventricular septum can be measured during sonographic fetal survey while viewing the left ventricular outflow tract (LVOT angle). Our aim was to compare the LVOT angle between fetuses with and without congenital heart malformations involving the LVOT. Methods: In this prospective cross-sectional study we measured the LVOT angle in fetuses with and without conotruncal anomalies. At the level of ‘‘4 chamber view’’ the transducer was tilted so that the LVOT was demonstrated, creating a ‘‘5 chamber view’’. The LVOT angle was measured during early systole at complete opening of the aortic valve, from the interventricular septum to the base of the aortic valve. Results: LVOT angle measurements were acquired from 299 fetuses at 15-38 weeks. LVOT angle were between 127-163 degrees, mean 148.2, independent of gestational age. The LVOT angle was significantly higher in fetuses with TGA or AS, compared with fetuses without heart malformations involving the LVOT (165.0 vs. 148.2, p<0.001). The LVOT angle was significantly lower in fetuses with AVC, compared with fetuses without heart malformations involving the LVOT (125.5 vs. 148.2, p<0.001). Conclusions: The LVOT angle does not change during pregnancy. The LVOT angle significantly differs between fetuses with and without heart malformations involving the LVOT.