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Updated: Jan 7, 2026
Transthoracic Speckle Tracking Echocardiography for the Quantitative Assessment of Left Ventricular Myocardial Deformation
Published on: October 20, 2016
Patterns of Segmental Strain of the Left Ventricle in Extremely Premature Infants
Tatiana Chumarnaya1,2, Evgeniya Gusarova1,2,3,4, Natalya Kosovtsova3
1Institute of Natural Sciences and Mathematics, Ural Federal University, 620002 Yekaterinburg, Russia.
Insights
This study established reference values for left ventricular (LV) segmental strain in extremely premature infants using speckle-tracking echocardiography (STE). Findings reveal strain gradients and regional differences, crucial for understanding cardiovascular health in this vulnerable population.
Area of Science:
- Neonatal Cardiology
- Pediatric Cardiovascular Research
- Echocardiography
Background:
- Extremely premature newborns face significant cardiovascular risks, including myocardial immaturity and hemodynamic instability.
- Limited research exists on myocardial strain in this population during the early neonatal period.
- Understanding left ventricular (LV) function is critical for managing cardiovascular complications.
Purpose of the Study:
- To assess left ventricular (LV) segmental strain in extremely premature newborns during the early neonatal period.
- To utilize speckle-tracking echocardiography (STE) for detailed strain analysis.
- To establish reference values for myocardial strain in this cohort.
Main Methods:
- Prospective study of 65 hemodynamically stable newborns (600-1500 g, 24-35 weeks gestational age) within 72 hours of birth.
- Speckle-tracking echocardiography (STE) was used to evaluate peak systolic strain (S), peak diastolic strain (G), and peak early systolic strain (P) in longitudinal, circumferential, and radial directions.
- Analysis included 18 LV segments, assessing time to peak strain and magnitude.
Main Results:
- Percentile tables for segmental strain characteristics in all three directions were generated.
- No significant dependence of segmental strain on birth weight, gestational age, or ductus arteriosus patency was observed.
- A base-to-apex gradient in longitudinal strain magnitude and maximal circumferential/radial strain in the LV septum were identified.
Conclusions:
- This is the first study to comprehensively compare longitudinal, circumferential, and radial LV strain using STE in hemodynamically stable, extremely premature infants.
- Established reference values provide a crucial baseline for future research and clinical assessment of cardiac function.
- The findings highlight regional variations in myocardial mechanics, informing the understanding of cardiovascular adaptation in preterm neonates.
Abstract:
Extremely premature newborns are predisposed to cardiovascular complications due to a number of factors, including myocardial immaturity, hemodynamic changes, and iatrogenic effects. There are few studies on myocardial strain in extremely premature infants during the early neonatal period. The objective of study was to assess the left ventricular (LV) segmental strain in extremely premature newborns during the early neonatal period by employing speckle-tracking echocardiography (STE). This prospective study examined 65 newborns with no signs of hemodynamic impairment during the first 72 h of life. The cohort had a range of birth weights (600-1500 g) and gestational ages (24-35 weeks). The peak strain in 18 LV segments during systole (peak S and time to peak S), and throughout the cardiac cycle (peak G and time to peak G), and during early systolic pre-stretch (peak P and time to peak P) were assessed in the longitudinal, circumferential, and radial directions. We obtained percentile tables of segmental strain characteristics in the longitudinal, circumferential, and radial directions. No dependence of segmental strain on the birth weight, gestational age, or arterial duct closure was found. A positive gradient of the longitudinal strain magnitude was observed from the base to the apex. The highest circumferential and radial strain were observed in LV septum. This study is the first to register and compare the longitudinal, circumferential, and radial LV strain using STE in extremely premature infants with no signs of hemodynamic disturbances during the first 72 h of life. Reference values for segmental strain were established.
