Can Real-Time Three-Dimensional (Four-Dimensional) and Speckle-Tracking Echocardiography Predict Cardiac Involvement...

This study aimed to evaluate usefulness of real-time three-dimensional (four-dimensional) and three-dimensional speckle-tracking echocardiography in detecting cardiac involvement identified by cardiac magnetic resonance imaging in children with Duchenne muscular dystrophy. This cross-sectional study included 18 boys with a median age of 11.9 years (10.5-13.2 years). Left ventricular ejection fraction, global and regional myocardial strains were assessed using real-time three-dimensional echocardiography and three-dimensional speckle-tracking echocardiography as well as magnetic resonance imaging. Late gadolinium enhancement was evaluated by cardiac magnetic resonance imaging. Moderately positive correlations were found for ejection fraction (r = 0.669, p = 0.003), global longitudinal strain (r = 0.618, p = 0.008), global circumferential strain (r = 0.513, p = 0.035), and global radial strain (r = 0.605, p = 0.01) measured by three-dimensional speckle-tracking echocardiography and cardiac magnetic resonance imaging. In addition, longitudinal and circumferential strain values measured by three-dimensional speckle-tracking echocardiography showed correlations with cardiac magnetic resonance imaging in the same segment and/or adjacent segments in 13 of 16 regions , with correlation coefficients between 0.487 and 0.776 (p < 0.05). Radial strain values demostrated correlations in 25 regions, with correlation coefficients between 0.487 and 0.690 (p < 0.05). Real-time three-dimensional echocardiography and three-dimensional speckle-tracking echocardiography provided valuable information about left ventricular function as well as global and regional myocardial strain compared with magnetic resonance imaging in our patients with Duchenne muscular dystrophy. Further studies including larger patient populations and a broader range of disease severity are needed to confirm these findings.