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Transthoracic Speckle Tracking Echocardiography for the Quantitative Assessment of Left Ventricular Myocardial Deformation
Published on: October 20, 2016
Tissue Doppler and speckle tracking echocardiography assessment of left ventricular function in children with cystic
Ozgur Kizilca1, Tulay Demircan1, Sakine Isik2
1Department of Pediatric Cardiology, Medical Faculty of Dokuz Eylul University, İzmir, Turkey.
Insights
Cystic fibrosis patients show early signs of left ventricular dysfunction detected by advanced echocardiography. Tissue Doppler imaging and speckle tracking echocardiography can identify subclinical changes in these patients.
Area of Science:
- Cardiology
- Pediatric Cardiology
- Medical Imaging
Background:
- Cystic fibrosis (CF) is a genetic disorder that can affect multiple organs, including the heart.
- Left ventricular (LV) dysfunction is a potential complication of CF, but early detection can be challenging with conventional methods.
Purpose of the Study:
- To investigate subclinical left ventricular (LV) dysfunction in pediatric patients with cystic fibrosis using advanced echocardiographic techniques.
- To compare cardiac function between CF patients and healthy controls.
Main Methods:
- Prospective cohort study involving 34 pediatric patients with cystic fibrosis and 37 healthy controls.
- Utilized tissue Doppler echocardiographic (TDI) imaging and two-dimensional speckle tracking echocardiography (STE) to assess LV function.
- Compared systolic and diastolic measurements, ejection fraction, myocardial performance indexes, and strain parameters between groups.
Main Results:
- While conventional measures like ejection fraction and septal/posterior wall function showed no significant differences, myocardial performance indexes were elevated in CF patients.
- STE revealed significant reductions in longitudinal strain in seven LV segments and circumferential strain in three LV segments in CF patients.
- Lower longitudinal and circumferential strain rates were observed in multiple LV segments in the CF group.
Conclusions:
- Tissue Doppler echocardiographic imaging and STE are valuable tools for identifying subclinical LV dysfunction in cystic fibrosis patients, even with normal conventional echocardiography.
- These advanced echocardiographic methods may be beneficial for routine monitoring of cardiac health in cystic fibrosis patients.
Background:
Cystic fibrosis may lead to left ventricular (LV) dysfunction. This dysfunction can be documented by methods such as tissue Doppler echocardiographic (TDI) imaging and two-dimensional speckle tracking echocardiography (STE) in early stage.
Study Design:
This was prospective cohort study.
Methods:
A total of 34 patients diagnosed with cystic fibrosis (mean age and SD 9.9 ± 4.9 years) and 37 healthy control subjects with a comparable gender and age distribution (mean age 9.8 ± 4.3) were studied. The results for the two groups were compared along with the results of published reports.
Results:
No significant relationship was found between the groups in terms of systolic and diastolic measurements of the interventricular septum and posterior left ventricular wall, and ejection fraction (P > .05). Myocardial performance indexes of left ventricular free wall and interventricular septum increased in the patient group compared with the controls (P < .05). As measured by STE, seven segments in the LV myocardial longitudinal strain and three segments in the LV myocardial circumferential strain showed significant reductions in patients with cystic fibrosis compared with controls (P < .05). The longitudinal global, circumferential global, and total global strain values had no significant difference between the groups (P > .05). Longitudinal strain rates and circumferential strain rates were both lower in five segments in the patient group (P < .05).
Conclusions:
Tissue Doppler echocardiographic imaging and STE may help identifying subclinical LV dysfunction in cystic fibrosis patients with unremarkable conventional echocardiography. They may be considered for the routine follow-up of cystic fibrosis patients.
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