Advanced Echocardiographic Characterization of Neonatal Ebstein's Anomaly Using Myocardial Deformation Imaging: A...

Area of Science:

• Cardiology
• Pediatric Cardiology
• Echocardiography

Background:

• Neonatal Ebstein's anomaly (EA) presents with hemodynamic instability and myocardial dysfunction.
• Abnormal right-heart geometry in EA challenges conventional echocardiography.
• Myocardial deformation imaging, specifically speckle-tracking echocardiography (STE), is valuable for assessing EA.

Purpose of the Study:

• To evaluate the utility of STE in assessing biventricular and biatrial myocardial deformation in neonates with EA.
• To compare myocardial deformation parameters between neonates with EA and healthy controls.
• To determine the diagnostic performance of STE in neonatal EA.

Main Methods:

• A retrospective observational study of 16 neonates with EA and 26 controls.
• Comprehensive transthoracic echocardiography including conventional 2D imaging and STE.
• Assessment of biventricular and biatrial myocardial deformation parameters.

Main Results:

• Neonates with EA showed significant structural remodeling and severe biventricular and biatrial dysfunction.
• STE revealed markedly reduced right ventricular longitudinal strain and impaired left ventricular global longitudinal strain in EA.
• Atrial reservoir, conduit, and contractile strain were severely impaired in both atria of neonates with EA.

Conclusions:

• STE enables early detection of extensive myocardial dysfunction in neonatal EA.
• STE captures abnormalities not fully identified by conventional echocardiography.
• STE provides significant incremental diagnostic value for neonatal EA.