Myocardial deformation in children post cardiac surgery, a cross-sectional prospective study
Mohammad Ahmad Hassan1,2, Ali Al-Akhfash3, Yasser Bhat3
1PSCCQ: Prince Sultan Cardiac Center in Qassim, Buraidah, Saudi Arabia. dmohamed81@gmail.com.
Insights
Pediatric cardiac surgery patients show reduced longitudinal strain, indicating impaired myocardial function. Speckle tracking echocardiography can detect these changes, aiding in long-term cardiac management.
Area of Science:
- Cardiology
- Pediatric Cardiac Surgery
- Echocardiography
Background:
- Speckle tracking echocardiography (STE) assesses myocardial deformation, offering insights into left ventricular function.
- Evaluating left ventricular strain via STE is crucial for monitoring cardiac function in pediatric patients post-cardiac surgery.
Purpose of the Study:
- To evaluate myocardial deformation using left ventricular strain as an indicator of cardiac function in children after cardiac surgery.
- To assess the utility of STE in pediatric outpatient follow-up visits post-cardiac surgery.
Main Methods:
- Prospective observational cross-sectional study of pediatric patients post-biventricular cardiac surgery.
- Two-dimensional speckle tracking echocardiography (2D STE) used to measure left ventricular strain.
- Measurements compared to age-specific reference values; patients grouped by age.
Main Results:
- Longitudinal strain values were significantly lower than reference values across age groups (p < 0.001).
- Global circumferential strain did not significantly differ from reference values.
- Increasing duration post-surgery correlated with improved longitudinal strain.
Conclusions:
- Myocardial deformation analysis via STE can identify cardiac function abnormalities not evident with traditional parameters.
- STE has potential implications for improved patient management and follow-up strategies in pediatric cardiac surgery survivors.
Background:
Myocardial deformation by speckle tracking echocardiography provides valuable information on the left ventricular function. The study aims to assess myocardial deformation in terms of left ventricular strain as an indicator of myocardial function in children after cardiac surgery at outpatient follow-up visits.
Methods:
The study design was a prospective observational cross-sectional study that included pediatric patients after biventricular cardiac surgery during the postoperative follow-up visits in the outpatient department. In addition to conventional echocardiographic examination, two-dimensional speckle tracking echocardiography was done to evaluate myocardial deformation in terms of left ventricular strain. Echocardiographic measurements were done offline and were compared to published reference normal values for age. Study subjects were divided according to age at follow-up into four groups (1 month-1 year, 1-2 years, 2-5 years, and 5-11 years).
Results:
Over ten months, 100 patients (64 males and 36 females) were included in the study. The median age was 30.8 months (IQR 12.8-65.3 months), the median weight was 11.7 kg (IQR 8-17 kg) and the median duration after surgery was 7.3 months (IQR 3.2-30.8 months). Longitudinal strain values were significantly (p < 0.001) lower than reference values for different age groups. Global circumferential strain showed no significant difference from the reference values. The duration after surgery had a statistically significant effect on longitudinal strain values, with improvement of the strain values with increasing intervals after surgery.
Conclusion:
Using myocardial deformation method to evaluate cardiac function may detect underlying cardiac function abnormalities even with normal traditional functional parameters, which could have implications for patient management and follow-up.
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