Developmental changes in the left ventricular diastolic wall strain on M-mode echocardiography

Area of Science:

• Cardiology
• Pediatric Echocardiography
• Biomedical Engineering

Background:

• Diastolic wall strain (DWS) is a proposed indicator of left ventricular (LV) wall stiffness.
• Current clinical use of DWS is limited by a lack of established normal values in pediatric populations, including neonates.

Purpose of the Study:

• To establish normal values for DWS in neonates and children using M-mode echocardiography.
• To investigate the relationship between DWS and other echocardiographic parameters of LV function across different age groups.

Main Methods:

• Measured DWS in 235 healthy individuals from neonates to adults, stratified into 8 age subgroups.
• Compared DWS with standard echocardiographic parameters: LV shortening fraction, Tei index, E/A, mitral annular velocities (s', e'), and E/e' ratio.

Main Results:

• DWS was significantly lower immediately after birth compared to older groups (p < 0.05), except for neonates aged 5-10 days.
• DWS peaked in the 1-9 years age group and subsequently decreased with age.
• Mitral annular early diastolic velocity (e') was the strongest predictor of DWS (β = 0.64).

Conclusions:

• Normal DWS values for the left ventricle vary significantly with age in pediatric populations.
• The reported data provide essential reference ranges for DWS, enabling its reliable use in M-mode echocardiography for children.