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Updated: Mar 14, 2026
Transthoracic Speckle Tracking Echocardiography for the Quantitative Assessment of Left Ventricular Myocardial Deformation
Published on: October 20, 2016
Postoperative assessment of left ventricular function by two-dimensional strain (speckle tracking) after paediatric
Elodie Perdreau1, Pierre-Emmanuel Séguéla1, Zakaria Jalal1
1Paediatric Cardiology Unit, hôpital Haut-Lévèque, Bordeaux University Hospital, Bordeaux, France.
Insights
Two-dimensional (2D) strain echocardiography is a feasible and reproducible method for assessing left ventricular (LV) function after pediatric cardiac surgery. This technique shows a correlation with aortic cross-clamping duration, unlike conventional methods.
Area of Science:
- Cardiology
- Pediatric Cardiac Surgery
- Echocardiography
Background:
- Left ventricular (LV) dysfunction is a complication of pediatric cardiac surgery with cardiopulmonary bypass, especially after prolonged aortic cross-clamping (ACC).
- Assessing occult myocardial injury using conventional echocardiography post-surgery can be challenging.
Purpose of the Study:
- To determine the feasibility of using two-dimensional (2D) strain echocardiography in the postoperative period.
- To assess the impact of aortic cross-clamping (ACC) duration on 2D strain measurements.
Main Methods:
- A prospective study included 33 pediatric patients (<18 years) with congenital heart disease undergoing cardiac surgery.
- Daily echocardiography, including LV ejection fraction and LV 2D strain, was performed from pre-surgery to postoperative day 5.
- Patients were grouped by ACC duration: <30 minutes, 30-80 minutes, and >80 minutes.
Main Results:
- 2D strain (longitudinal, circumferential, radial) demonstrated good feasibility and reproducibility, outperforming LV ejection fraction in intra- and interobserver agreement.
- Postoperative longitudinal and circumferential strain patterns differed significantly across ACC duration groups (P<0.001).
- Conventional echocardiographic variables did not show significant differences between groups.
Conclusions:
- Postoperative LV 2D strain is a feasible and reproducible echocardiographic method for evaluating pediatric cardiac surgery patients.
- 2D strain measurements appear to correlate with the duration of aortic cross-clamping, offering a more sensitive assessment of myocardial injury.
Background:
Left ventricular (LV) dysfunction may complicate paediatric cardiac surgery with cardiopulmonary bypass, notably after long aortic cross-clamping (ACC). Assessment of occult myocardial injury by conventional echocardiographic variables may be difficult in the postoperative period.
Aims:
To evaluate the feasibility of two-dimensional (2D) strain in the postoperative period, and to assess the effect of ACC duration on this variable.
Methods:
Thirty-three paediatric patients (age<18years) with congenital heart disease undergoing cardiac surgery with cardiopulmonary bypass were included in this prospective single-centre study. Daily echocardiography was performed from the day before surgery to the fifth postoperative day. LV ejection fraction and LV 2D strain were measured. The cohort was divided into three groups according to ACC duration (group 1:<30minutes; group 2: 30-80minutes; group 3:>80minutes).
Results:
Mean age and weight were 4.2±2.5years and 15.1±5.2kg, respectively. Feasibilities of longitudinal, circumferential and radial strains were good, and quite similar to conventional variables. Compared with conventional variables, intra- and interobserver agreements regarding 2D strain were better (r=0.916, P<0.001 and r=0.855, P<0.001 for longitudinal strain versus r=0.156, P=0.54 and r=0.064, P=0.80 for LV ejection fraction by Simpson's method). Postoperative evolution of longitudinal and circumferential strains was significantly different between the three groups (P<0.001), whereas there was no difference using conventional variables.
Conclusion:
Postoperative LV 2D strain is a feasible and reproducible method. Strain measurements seem to indicate correlation with ACC duration.
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