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Updated: Mar 21, 2026
Transthoracic Speckle Tracking Echocardiography for the Quantitative Assessment of Left Ventricular Myocardial Deformation
Published on: October 20, 2016
Long-term cardiac consequences of fetal exposure to preeclampsia: a speckle tracking echocardiography analysis
Hazer Ercan Bozyer1, Veysel Celiktepe2, Yagmur Damla Onal2
1Department of Child Health and Diseases, Division of Pediatric Cardiology, Dokuz Eylul University, Inciralti, 35340, Izmir, Turkey. hazer.ercanbozyer@deu.edu.tr.
Insights
Children exposed to preeclampsia (PE) in utero show early signs of heart dysfunction, detectable with advanced echocardiography. Conventional methods may miss these subtle changes, highlighting the need for specialized monitoring in this high-risk group.
Area of Science:
- Cardiology
- Pediatrics
- Obstetrics
Background:
- Preeclampsia (PE) poses long-term cardiovascular risks to offspring.
- Subclinical cardiac effects in children exposed to PE require further investigation.
- Two-dimensional speckle tracking echocardiography (2D-STE) can detect subtle myocardial dysfunction.
Purpose of the Study:
- To evaluate long-term cardiac function in children born to mothers with preeclampsia.
- To compare cardiac function using conventional and 2D-STE methods.
- To assess the impact of PE onset timing on offspring cardiac health.
Main Methods:
- Prospective cross-sectional study comparing 48 offspring of PE pregnancies with 48 controls (aged 2-12 years).
- Standard echocardiography and advanced myocardial strain parameters (GLS, GCS) assessed.
- Subgroup analysis based on early vs. late PE onset.
Main Results:
- Conventional echocardiography showed no systolic differences, but a lower mitral E/A ratio in the PE group indicated diastolic dysfunction.
- 2D-STE revealed significantly reduced global longitudinal strain (GLS) and global circumferential strain (GCS) in the PE group.
- No significant differences in strain parameters were found between early- and late-onset PE subgroups.
Conclusions:
- Prenatal PE exposure leads to subclinical left ventricular systolic and diastolic dysfunction in children.
- Advanced echocardiography (2D-STE) is essential for detecting these early impairments, as conventional methods may be insufficient.
- Long-term cardiac monitoring with 2D-STE is recommended for children exposed to PE, irrespective of PE onset timing.
Background:
Preeclampsia (PE) is associated with long-term cardiovascular risks in offspring, but its subclinical cardiac impact remains underexplored. This study aimed to evaluate the long-term cardiac function in children born to preeclamptic mothers using conventional and two-dimensional speckle tracking echocardiography (2D-STE).
Methods:
In this prospective cross-sectional study, 48 offspring (aged 2-12 years) of preeclamptic pregnancies were compared with 48 age- and sex-matched controls. Standard echocardiographic measurements and advanced myocardial strain parameters (total global longitudinal strain [TGLS], total global circumferential strain [TGCS]) were assessed. Subgroup analyses were performed based on the timing of PE onset (early vs. late). Statistical significance was set at p < 0.05.
Results:
No significant differences were observed in conventional echocardiographic systolic indices (EF, FS, TAPSE). However, the mitral E/A ratio was significantly lower in the PE group (p = 0.0099), suggesting early diastolic dysfunction. 2D-STE revealed significantly reduced total GLS (- 25.8 ± 1.5 vs - 28.3 ± 2.3, p < 0.0001) and mid-level GCS (- 25.0 ± 3.5 vs - 26.9 ± 4.4, p = 0.0175) in the PE group. No differences in strain parameters were observed between early-onset and late-onset PE subgroups. Although anthropometric measures (weight and height) were lower in the PE group, SDS values were not statistically different.
Conclusions:
Children exposed to PE in utero demonstrate subclinical alterations in left ventricular systolic and diastolic function, detectable only via advanced echocardiographic methods. Conventional echocardiographic parameters may fail to detect these early functional impairments. Long-term cardiac monitoring using 2D-STE could be crucial for this at-risk population, regardless of PE onset timing.
What Is Known:
• Prenatal exposure to preeclampsia may affect cardiovascular structure and function in offspring. • Speckle-tracking echocardiography is a sensitive method for detecting subclinical myocardial dysfunction.
What Is New:
• Myocardial strain abnormalities were detected by speckle-tracking echocardiography despite normal conventional echocardiographic parameters. • These findings highlight the value of speckle-tracking echocardiography in identifying subclinical myocardial dysfunction in children exposed to preeclampsia.
