Speckle tracking derived strain in infants with severe perinatal asphyxia: a comparative case control study

Area of Science:

• Neonatal Cardiology
• Pediatric Cardiac Imaging
• Biomarkers of Myocardial Injury

Background:

• Speckle tracking echocardiography (STE) is a valuable tool for assessing cardiac function in neonates.
• Perinatal asphyxia can lead to myocardial injury and impaired cardiac function in newborns.
• Early detection of cardiac dysfunction is crucial for timely intervention and improved outcomes.

Purpose of the Study:

• To compare speckle tracking strain indices between neonates with perinatal asphyxia and healthy controls.
• To investigate the correlation between strain indices, 2D Doppler-derived cardiac output, and serum troponin levels in asphyxiated infants.

Main Methods:

• Retrospective analysis of clinical and echocardiographic data from asphyxiated infants undergoing therapeutic hypothermia.
• Prospective data collection from a cohort of healthy infants for comparison.
• Pearson's coefficient of correlation was used to assess relationships between variables.

Main Results:

• Asphyxiated infants exhibited significantly impaired left ventricular global longitudinal strain (GLS) compared to healthy controls (-11.01% vs -21.45%, p <0.001).
• Cardiac output was markedly lower in asphyxiated infants (97 ml/kg/min vs 230 ml/kg/min).
• GLS showed a positive correlation with cardiac output (r² = 0.86, p<0.001) and a negative correlation with troponin levels (r² = 0.64, p<0.001) in asphyxiated infants.

Conclusions:

• Two-dimensional speckle tracking-derived strain is significantly impaired in neonates suffering from perinatal asphyxia.
• GLS demonstrates significant correlations with cardiac output and troponin levels, serving as a potential indicator of myocardial injury.
• Strain analysis may aid in risk stratification and management of neonatal cardiac dysfunction.