Speckle tracking derived strain in neonates: planes, layers and drift

Area of Science:

• Cardiology
• Medical Imaging
• Neonatal Physiology

Background:

• Accurate assessment of myocardial strain in neonates is crucial for early detection of cardiac dysfunction.
• Speckle tracking echocardiography is a valuable tool for quantifying myocardial deformation.
• Standardization of speckle tracking parameters is needed for reliable neonatal cardiac assessment.

Purpose of the Study:

• To evaluate the impact of different imaging models (3-plane vs. 4-chamber) and drift compensation on speckle tracking-derived global longitudinal strain in neonates.
• To investigate the influence of assessing strain in different myocardial layers (endocardial, mid-myocardial, epicardial).
• To analyze the interplay between imaging models, drift compensation, and myocardial layer assessment on strain variability and observer agreement.

Main Methods:

• Speckle tracking echocardiography was performed on 22 healthy neonates.
• Global longitudinal strain was analyzed using both 3-plane and 4-chamber models, with and without drift compensation.
• Statistical analyses included ANOVA, Bland-Altman analysis, coefficients of variation, and intraclass correlation coefficients to assess variability and agreement.

Main Results:

• Neither the 3-plane nor 4-chamber model, nor drift compensation, significantly altered global longitudinal strain (<1% difference).
• A strain gradient was observed, with higher strain in epicardial layers compared to endocardial layers.
• Drift compensation increased discrepancy in segmental strain values more than in global longitudinal strain.

Conclusions:

• Global longitudinal strain in healthy neonates is robust to variations in imaging models and drift compensation.
• Myocardial strain exhibits a layer-dependent gradient, consistent with findings in older populations.
• Drift compensation may introduce variability in regional strain analysis, necessitating careful consideration in neonatal studies.