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Updated: May 8, 2026
Transthoracic Speckle Tracking Echocardiography for the Quantitative Assessment of Left Ventricular Myocardial Deformation
Published on: October 20, 2016
Left ventricular flow dynamics in preterm infants assessed with high frame rate echocardiography with blood speckle
Koert de Waal1, Edward Crendal1, Solveig Fadnes2,3
1John Hunter Children's Hospital, Department of Neonatology, The University of Newcastle, Newcastle, New South Wales, Australia.
Abstract:
The typical intracardiac blood flow pattern of a healthy left ventricle includes vortex formations to help store energy, facilitate valve closure, and propagation of blood flow toward the outflow tract. Intracardiac blood flow patterns can be visualized with high frame rate echocardiography with blood speckle tracking (BST) and analyzed for measures of cardiac efficiency such as kinetic energy (KE), energy loss (EL), vorticity (VO), and vortex complexity (VC). Preterm infants are at high risk of cardiac compromise, but mechanistic pathways are unclear. The aim of this study is to gather BST reference values in stable preterm infants. Stable low-risk preterm infants < 30 wk' gestation underwent echocardiography with BST early and late in the neonatal admission period. PyUSview software was used for intracardiac flow analysis. We included 55 stable preterm infants. KE, EL, VO, and VC were significantly higher in diastole when compared with systole, and most BST parameters increased during the admission period. EL/KE as a measure of cardiac efficiency remained stable around 3% during systole, but EL/KE during diastole increased from 4.9% to 9.2% along with increasing E and A velocities, which is higher than reported in healthy term infants. Reference ranges of BST intracardiac flow parameters in stable low-risk preterm infants suggest relatively poor cardiac inflow efficiency due to high EL. This data can assist in the development of further clinical applications for BST in preterm infants, such as predicting disease progression, monitoring treatments, and early diagnosis of adverse left ventricular remodeling.NEW & NOTEWORTHY In this study, we explored a subgroup of newborns with high risk of cardiac failure during their intensive care stay, the very preterm infant. We present reference values for blood speckle-tracking-derived measures of cardiac efficiency. This data can assist in the development of further clinical applications for echo blood speckle tracking in preterm infants, such as predicting disease progression, monitoring treatments, and early diagnosis of adverse left ventricular (LV) remodeling.
