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Updated: Jan 20, 2026

Transthoracic Speckle Tracking Echocardiography for the Quantitative Assessment of Left Ventricular Myocardial Deformation
09:05

Transthoracic Speckle Tracking Echocardiography for the Quantitative Assessment of Left Ventricular Myocardial Deformation

Published on: October 20, 2016

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Subclinical myocardial disease in patients with primary hyperoxaluria and preserved left ventricular ejection

Ruth Lagies1, Floris E A Udink Ten Cate2,3, Markus Feldkötter4

  • 1Department of Pediatric Cardiology, Children's Hospital, University of Bonn, Adenauerallee 119, 53113, Bonn, Germany.

Pediatric Nephrology (Berlin, Germany)
|August 24, 2019
PubMed

Insights

Subclinical myocardial disease is present early in primary hyperoxaluria (PH) patients, even with preserved heart function. Strain imaging detects this early cardiac dysfunction, suggesting revised screening recommendations for PH patients.

Area of Science:

  • Cardiology
  • Nephrology
  • Medical Imaging

Background:

  • Primary hyperoxaluria (PH) is a genetic disorder causing chronic kidney disease (CKD) and systemic oxalate deposition.
  • Myocardial dysfunction may occur early in PH, but this has not been previously investigated.
  • Early detection of cardiac involvement in PH is crucial for timely intervention.

Purpose of the Study:

  • To investigate subclinical myocardial disease in asymptomatic primary hyperoxaluria patients using 2D speckle tracking echocardiography (2D-STE).
  • To assess if 2D-STE can detect early cardiac dysfunction before overt symptoms manifest.

Main Methods:

  • A prospective study involving pediatric and adolescent PH patients with preserved LV ejection fraction (EF) and no renal replacement therapy.
  • Conventional echocardiography and 2D-STE were performed to measure global (GLS) and segmental longitudinal strain (LS).
  • Data were compared to age- and gender-matched controls, with Z-scores calculated.

Main Results:

  • Fifteen PH patients (mean age 14.1 years) showed significantly impaired GLS (-17.1 ± 2.2%) compared to controls (-22.4 ± 1.9%), despite preserved LV EF (63 ± 6%).
  • Impaired GLS was primarily due to reduced LS in apical segments and correlated with increased ventricular wall thickness and serum creatinine.
  • No correlation was found between GLS and blood pressure.

Conclusions:

  • Subclinical myocardial disease is present early in PH patients, even with preserved LV EF and early CKD.
  • 2D-STE can detect this early cardiac dysfunction in PH.
  • Current screening guidelines for cardiac disease in PH patients may need revision to include those with earlier stages of CKD.
Abstract

Keywords:
Global longitudinal strainOxalosisPrimary hyperoxaluria deformation imagingRisk factorsSpeckle tracking

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