First Comprehensive Model of a Fully Functioning Fetal Heart Created

A combination of abdominal fetal electrocardiograms (ECGs) and two different magnetic resonance imaging (MRI) scans has been used to create a comprehensive model of a fully functioning fetal heart.

Researchers at the University of Leeds (United Kingdom) and the University of Nottingham (United Kingdom) recorded weekly abdominal fetal ECG readings from 18 weeks gestation until just before delivery. Using complex algorithms to correctly identify signals related to the fetal heart rate (FHR) via sensitive ECG-style electrodes, the researchers succeeded in developing a modeling method based on electrophysiological signals, and not on physical changes (such as change in reflected sound waves and changes on strain gauge) that may cause problems in data interpretation.

The ECG data, alongside two different MRI scans from the hearts of dead fetuses, was incorporated into a three dimensional (3D) computerized model that identified the structure, shape, and size of the different components of the heart. According to the researchers, early results suggest that the human heart may develop on a different timeline from other mammals. While the tissue in a pig heart develops a highly organized structure at a relatively early stage of a fetus’ development, there is little organization in the human heart’s cells until 20 weeks into pregnancy; despite this, the human heart has a regular heartbeat from about 22 days. The study was published in the April 2013 issue of the Journal of the Royal Society Interface Focus.

“The development of the fetal human heart is on a totally different timeline, a slower timeline, from the model that was being used before. This upsets our assumptions and raises new questions,” said senior author Prof. Arun Holden, PhD, of the University of Leeds’ School of Biomedical Sciences. “Since the wall of the heart is structurally disorganized, we might expect to find arrhythmias, which are a bad sign in an adult. It may well be that in the early stages of development of the heart arrhythmias are not necessarily pathological and that there is no need to panic if we find them.”

“Effectively, at the moment, fetal ECGs are not really used. The textbooks descriptions of the development of the human heart are still founded on animal models and 19th century collections of abnormalities in museums,” added Professor Holden. “If you are trying to detect abnormal activity in fetal hearts, you are only talking about third trimester and postnatal care of premature babies. By looking at how the human heart actually develops in real life and creating a quantitative, descriptive model of its architecture and activity from the start of a pregnancy to birth, you are expanding electrocardiology into the fetus.”

Developing an accurate, computerized simulation of the fetal heart is critical to understanding normal heart developments in the womb and, eventually, to opening new ways of detecting and dealing with some functional abnormalities about the fetus early in pregnancy, using noninvasive monitoring of the pregnant mother.

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University of Leeds
University of Nottingham