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Updated: Dec 15, 2025
Transthoracic Speckle Tracking Echocardiography for the Quantitative Assessment of Left Ventricular Myocardial Deformation
Published on: October 20, 2016
Detection of Early Myocardial Injury in Children with Ventricular Septal Defect Using Cardiac Troponin I and
Alyaa A Kotby1, Manal M Abd Al Aziz2, Adel H Husseiny1
1Pediatric Department, Pediatric Cardiology Unit, Faculty of Medicine, Ain Shams University, Ramsis Street, Abbasia, Cairo, 11566, Egypt.
Insights
Serum cardiac troponin I (cTnI) effectively detects early myocardial injury in children with ventricular septal defects (VSDs). Two-dimensional speckle tracking echocardiography (2D-STE) did not show significant changes, indicating cTnI
Area of Science:
- Pediatric Cardiology
- Cardiovascular Research
- Biomarker Discovery
Background:
- Ventricular septal defects (VSDs) cause hemodynamic overload, leading to myocardial injury and heart failure in children.
- Conventional echocardiography often fails to detect early-stage myocardial damage.
- Cardiac troponin I (cTnI) and 2D speckle tracking echocardiography (2D-STE) are advanced tools for cardiovascular assessment.
Purpose of the Study:
- To evaluate the efficacy of serum cTnI and 2D-STE in the early detection of VSD-induced myocardial injury in children.
- To compare these markers between VSD patients (symptomatic and asymptomatic) and healthy controls.
Main Methods:
- Study included 30 children with VSD and 30 controls.
- Serum cTnI levels were measured.
- Conventional echocardiography and 2D-STE were performed to assess global peak longitudinal systolic strain [G peak SL(AVG)].
Main Results:
- Serum cTnI levels were significantly elevated in VSD patients compared to controls and higher in symptomatic vs. asymptomatic groups.
- Serum cTnI showed positive correlations with left atrial and left ventricular dimensions and a negative correlation with G peak SL(AVG).
- No significant differences in G peak SL(AVG) were observed between VSD patients and controls or between symptomatic and asymptomatic groups.
Conclusions:
- Serum cTnI is a sensitive biomarker for early myocardial injury in pediatric VSD patients, preceding ventricular dilation or dysfunction.
- Peak longitudinal systolic strain measured by 2D-STE is not significantly affected despite elevated serum cTnI levels in this cohort.
- cTnI offers a valuable tool for early diagnosis and monitoring of myocardial health in children with VSDs.
Abstract:
Children with ventricular septal defects (VSDs) are subjected to hemodynamic overload which causes myocardial injury and subsequent heart failure. Early stages of myocardial damage cannot be detected by conventional echocardiography. Two-dimensional speckle tracking echocardiography (2D-STE) and cardiac troponin I (cTnI) have been recently introduced as more accurate tools for early assessment of cardiovascular diseases. The purpose of this study is to evaluate the role of cardiac troponin I (cTnI) and 2D-STE in the early detection of VSD-induced myocardial injury. Thirty children with VSD (symptomatic and asymptomatic) and 30 controls were assessed serologically by measuring serum cTnI and by conventional echocardiography. STE was performed to measure the averaged global peak longitudinal systolic stain [G peak SL(AVG)]. Serum cTnI levels were significantly higher in patients when compared to controls (P < 0.05) and in the symptomatic group when compared to the asymptomatic group (P < 0.05). Serum cTn I level correlated positively with the left atrial (r = 0.37, P = 0.045) and left ventricular dimensions (r = 0.46, P = 0.01) and negatively with the G peak SL(AVG) (r = -0.39, P = 0.03). There were no statistically significant differences between patients and controls or between symptomatic and asymptomatic groups with regard to the G peak SL(AVG). The peak longitudinal systolic strain (measured by 2D-STE) is not affected despite the elevation of serum cTnI. Serum cTnI is a sensitive marker for early detection of myocardial injury in VSD patients even before the development of ventricular dilatation or dysfunction.
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