Related Experiment Video
Updated: May 12, 2026
Assessing Intracardiac Vortices with High Frame-Rate Echocardiography-Derived Blood Speckle Imaging in Newborns
Published on: December 22, 2023
Assessment of intraventricular time differences in healthy children using two-dimensional speckle-tracking
Liselotte M Klitsie1, Arno A W Roest, Annelies E van der Hulst
1Department of Pediatric Cardiology, Leiden University Medical Center, Leiden, The Netherlands.
Insights
Speckle-tracking strain imaging is feasible in children for assessing intraventricular time differences. While age and heart rate do not significantly affect these parameters, reproducibility issues limit their clinical use.
Area of Science:
- Pediatric cardiology
- Echocardiography
- Cardiac mechanics
Background:
- Intraventricular time differences are increasingly assessed in pediatric populations.
- Understanding the applicability of adult echocardiographic techniques in children is crucial.
- Speckle-tracking strain imaging offers advanced assessment of cardiac function.
Purpose of the Study:
- To evaluate the feasibility and applicability of speckle-tracking strain-derived parameters in children.
- To specifically assess the age and heart rate dependency of these parameters in pediatric subjects.
- To determine the reproducibility of intraventricular time difference parameters in a pediatric cohort.
Main Methods:
- 183 healthy children (0-19 years) underwent speckle-tracking strain imaging.
- Longitudinal, radial, and circumferential strain parameters were analyzed.
- Age and heart rate dependency were assessed via regression analysis; variability was tested.
Main Results:
- Successful analysis of longitudinal strain curves in 94.8% and radial/circumferential in 89.5% of subjects.
- No significant linear relationship found between age/heart rate and intraventricular time difference parameters.
- Time to global peak strain showed good reproducibility (CV <10), unlike intraventricular time difference parameters (CV >10).
Conclusions:
- Speckle-tracking strain analysis demonstrates good feasibility in children.
- Age and heart rate do not linearly influence parameters of intraventricular time differences.
- Limited reproducibility of certain intraventricular time difference parameters restricts their clinical application in pediatrics.
Background:
Parameters describing intraventricular time differences are increasingly assessed in both adults and children. However, to appreciate the implications of these parameters in children, knowledge of the applicability of adult techniques in children is essential. Hence, the aim of this study was to assess the applicability of speckle-tracking strain-derived parameters in children, paying special attention to age and heart rate dependency.
Methods:
One hundred eighty-three healthy subjects (aged 0-19 years) were included. Left ventricular global peak strain, time to global peak strain, and parameters describing intraventricular time differences were assessed using speckle-tracking strain imaging in the apical two-chamber, three-chamber, and four-chamber views (longitudinal strain) and the parasternal short-axis view (radial and circumferential strain). Parameters describing intraventricular time differences included the standard deviation of time to peak strain and differences in time to peak strain between two specified segments. Age and heart rate dependency were evaluated using regression analysis, and intraobserver and interobserver variability were tested.
Results:
Acquisition and analysis of longitudinal six-segment time-strain curves was successful in 94.8% of subjects and radial and circumferential time-strain curves in 89.5%. No clinically significant linear relation was observed between age or heart rate and parameters describing intraventricular time differences. The coefficient of variation of time to global peak strain parameters was <10, while it was >10 for parameters describing intraventricular time differences.
Conclusions:
The feasibility of speckle-tracking strain analysis in children is relatively good. Furthermore, no linear relation was observed between age or heart rate and parameters describing intraventricular time differences. However, the limited reproducibility of some parameters describing intraventricular time differences will confine their applicability in clinical practice.
