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Updated: May 6, 2026
Transthoracic Speckle Tracking Echocardiography for the Quantitative Assessment of Left Ventricular Myocardial Deformation
Published on: October 20, 2016
Speckle tracking derived strain in infants with severe perinatal asphyxia: a comparative case control study
Arvind Sehgal1, Flora Wong, Samuel Menahem
1Monash Newborn, Monash Medical Centre, Melbourne, VIC 3168, Australia. arvind.sehgal@monash.edu.
Insights
Speckle tracking echocardiography revealed impaired cardiac function in asphyxiated infants, showing reduced global longitudinal strain (GLS). This strain correlated with cardiac output and troponin levels, indicating its utility in assessing myocardial injury in neonates.
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.
Background:
Speckle tracking echocardiography is increasingly being used to assess cardiac function in neonates. The objective was to compare speckle tracking strain indices between asphyxiated infants and healthy controls and to ascertain correlations between strain and 2D Doppler derived indices and cardiac troponin (biochemical marker of myocardial injury).
Methods:
Clinical and echocardiographic data from severely asphyxiated infants undergoing therapeutic hypothermia was evaluated retrospectively. This was compared with prospective data from healthy infants. Correlations between variables were assessed using Pearson's coefficient of correlation.
Results:
Twenty four infants with severe perinatal asphyxia were admitted during the study period of which 3 were not cooled and were excluded. The gestational age and birth weights of cases and controls were comparable. The mean left ventricular global longitudinal strain (GLS) from apical 4 chamber view was noted to be significantly impaired in the asphyxiated infants (- 11.01% ± 2.48 vs - 21.45% ± 2.74, p <0.001). Cardiac output was significantly lower in the asphyxiated infants (97 ± 26 vs 230 ± 60 ml/kg/min). In asphyxiated infants, GLS correlated positively with cardiac output (r2 = 0.86, p< 0.001) and negatively with serum troponin levels (r2 = 0.64, p< 0.001). GLS was less impaired in infants on inotropes compared to those not on inotropic support, -12.55% (1.9) vs -10.2% (1.3), p= 0.018. Infants who died had a lower global strain value compared to survivors, - 9.7% (1.6) vs - 12.8% (2.6), p = 0.02.
Conclusions:
2D Speckle derived strain was impaired in asphyxiated infants. Significant correlations between GLS and cardiac output and troponin were noted.
