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Basal-Predominant Right-Ventricular Dysfunction in Pediatric Dilated Cardiomyopathy: An Integrated Biventricular
Iolanda Muntean1,2, Diana Ramona Iurian2,3, Asmaa-Carla Hagau3,4
1Department of Pediatrics III, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureș, 540136 Targu Mures, Romania.
Biomedicines
|January 28, 2026
Summary
Pediatric dilated cardiomyopathy (DCM) involves the right ventricle (RV) with reduced RV strain, particularly at the base. Biventricular strain analysis aids in identifying children with advanced functional limitations.
Area of Science:
- Pediatric Cardiology
- Cardiovascular Imaging
- Biomedical Engineering
Background:
- Right-ventricular (RV) involvement in pediatric dilated cardiomyopathy (DCM) is increasingly recognized.
- RV deformation characteristics and their link to functional status in pediatric DCM require further definition.
Purpose of the Study:
- To investigate RV deformation patterns in children with DCM using two-dimensional speckle-tracking echocardiography (2D-STE).
- To assess the relationship between RV strain indices and functional limitation in pediatric DCM.
- To evaluate the utility of biventricular strain analysis for functional stratification.
Main Methods:
- Compared 29 children with DCM to age- and sex-matched controls using conventional echocardiography and 2D-STE.
- Analyzed segmental RV and left ventricular (LV) strain using a linear mixed-effects model.
- Evaluated associations between strain and advanced functional class (NYHA/Ross III-IV) via logistic regression and ROC analysis.
Main Results:
- Children with DCM exhibited impaired biventricular function and reduced RV strain compared to controls (p < 0.05).
- RV strain reduction was predominantly basal.
- RV free-wall longitudinal strain (RVFWSL) and LV global longitudinal strain (LVGLS) correlated with conventional parameters and predicted advanced functional class.
Conclusions:
- Pediatric DCM features RV involvement with a basal-dominant deformation pattern.
- Biventricular strain assessment, particularly combining RVFWSL and LVGLS, enhances the identification and functional stratification of children with advanced DCM.
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