Reference values and Z-scores for left ventricular global longitudinal strain in healthy Colombian children: an...

Left ventricular global longitudinal strain (GLS) is a sensitive marker of systolic function that enables detection of subclinical myocardial dysfunction. Reference values are derived largely from non-Latin American populations, despite known demographic variability. We sought to establish GLS reference values in a cohort of healthy children from a Latin American country.

This observational study included 321 healthy children older than 2 years stratified by age (2-6, 7-12, and 13-17 years). Anthropometric, physiologic, and echocardiographic variables were assessed, including left ventricular ejection fraction, velocity-time integral, and GLS. GLS distributions were analyzed by age and sex using z-scores, and correlations with echocardiographic measures were examined. Among 321 participants (median age, 10 years; interquartile range, 6-14), anthropometric measures and blood pressure increased with age, whereas heart rate declined. Left ventricular ejection fraction remained normal across groups. GLS varied significantly by age, with more negative values in younger children and progressively less negative values in adolescents. GLS demonstrated a moderate correlation with age (r = 0.49; p < 0.001) and a weak correlation with ejection fraction.

GLS in this population showed significant variation with age, becoming less negative in older children. A concordance was observed between myocardial deformation and traditional volumetric measures. These findings provide population-specific reference values and highlight the importance of considering age when interpreting GLS.