Myocardial Function in Fetuses with Congenital Cytomegalovirus Infection

Abstract

<b><i>Introduction:</i></b> The objective of this study was to investigate myocardial deformation of left (LV) and right ventricle (RV) using 2-dimensional speckle-tracking echocardiography (2D-STE) in fetuses with and without congenital cytomegalovirus (CMV) infection. <b><i>Methods:</i></b> This was a prospective single-center study. Vertical transmission was defined by a positive CMV polymerase chain reaction (PCR) test on the amniotic fluid or on the neonate’s urine. Fetuses were divided into group 1 and group 2 if CMV-PCR was positive or negative, respectively. LV and RV global longitudinal strain (GLS) values were obtained and adjusted for gestational age by calculating Z-scores. Univariate analysis was carried out to compare cardiac indices between group 1 and group 2. <b><i>Results:</i></b> Fetuses from group 1 (<i>n</i> = 11) had a significantly lower LV myocardial shortening than those from group 2 (<i>n</i> = 32). GLS was −20.7 ± 5.2% and −26.3 ± 4.1%, respectively (<i>p</i> = 0.001). Similarly, GLS Z-score was lower (0.02 ± 0.72) in group 1 than in group 2 (−0.80 ± 0.59) (<i>p</i> = 0.001). Similarly, RV GLS Z-score was significantly impaired in group 1 compared to group 2 (−0.44 ± 1.03 vs. −1.04 ± 0.71, <i>p</i> = 0.041). <b><i>Conclusion:</i></b> Fetuses with congenital CMV showed subclinical biventricular myocardial dysfunction. Further studies are needed to confirm the potential role of 2D-STE in identifying fetuses with congenital CMV at risk of postnatal cardiovascular morbidities.