Objective To investigate the changes in myocardial deformation in donor and reeipient hearts in response to selective fetoscopic laser photocoagulation (SFLP) for twin-twin transfusion syndrome (TTTS).Methods Totally 25 twin pairs before 24-hour and 1 week after SFLP had fetal echocardiography and digital dynamic two-dimensional four chamber views which were interrogated off-line using velocity vector imaging (VVI) software.Global longitudinal strain (S),systolic strain rate (SRs) and diastolic strain rate (SRd) were measured off-line in the left (LV) and right (RV) ventricles.Results In the donor,SFLP resulted in increase in cardiothoracic ratio ( CTR,0.29 ± 0.03 versus 0.34 ± 0.05,P ＜ 0.01 ),with development of new onset tricupid regurgitation ( n =7 ) and pericardial effusion ( n =5 ) and worsening of all measures of myocardial deformation in both systole and diastole for LV and RV [ LV-S:( - 19.24 ± 3.68 )％ versus (-13.78±3.64)％,P＜0.01; LV-SRs:(-2.28±0.53) versus (-1.43 ±0.41) s-1,P＜ 0.01 ; LV-SRd:( 1.67 ± 0.43 ) versus ( 1.15 ± 0.70) s - 1,P ＜ 0.01 ; RV-S:( - 20.20 ± 3.19) ％ versus (-16.10±3.07)％,P＜0.01; RV-SRs:(-2.03 ±0.65) versus (-1.72±0.38) s-1,P＜0.05; RV-SRd:( 1.71 ±0.30) versus ( 1.50 ±0.36) s-1,P ＜0.05].In the recipient,CTR decreased (0.42 ± 0.04 versus 0.37 ±0.04,P ＜0.01 ) and all parameters for both LV and RV improved substantially [ LV-S:( - 10.62 ± 2.72) ％ versus ( - 16.46 ± 3.23 ) ％,LV-SRs:( - 1.09 ± 0.30) versus ( - 1.60 ± 0.31 ) s-1,LV-SRd:(0.99 ± 0.34) versus (1.53 ± 0.32) s-1,RV-S:( - 11.66 ± 4.56)％ versus ( - 17.96 ± 3.97 ) ％,RV-SRs:( - 1.26 ± 0.39) versus ( - 1.74 ± 0.45 ) s-1,RV-SRd:( 1.15 ± 0.49) versus ( 1.63 ± 0.44 ) s- 1 ; all P ＜ 0.01 ].Conclusion Myocardial deformational mechanics improve in the recipient but worsen in the donor following SFLP for TTTS.

Objective To investigate the differences in myocardial deformation between donor and recipient in twin-twin transfusion syndrome(TTTS) using vector velocity imaging( VVI). Methods Digital dynamic two-dimensional four chamber views were interrogated off-line using VVI software. Global longitudinal strain(S) , systolic strain rate(SRs) and diastolic strain rate(SRd) were measured in the left ventricles(LV) and right ventricles (RV) of 30 fetal pairs with TTTS and compared to 30 gestational age-matched normal controls. Results Donor LV-SRs was higher, while donor RV-SRd was significantly lower than controls. Recipient S, SRs and SRd were significantly lower for both LV and RV in comparison to controls. Conclusions In TTTS,donor LV systolic function is hyperdynamic while the RV diastolic function is low. Recipient RV and LV are both globally depressed with systolic and diastolic dysfunction.