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Transthoracic Speckle Tracking Echocardiography for the Quantitative Assessment of Left Ventricular Myocardial Deformation
Published on: October 20, 2016
Right ventricular function in children with asthma: tissue doppler and two-dimensional speckle-tracking
Ezgi Topyildiz1, Deniz Ozceker2, Ramime Ozel3
1Department of Pediatric Allergy and Immunology, Acibadem Atasehir Hospital, Istanbul, Türkiye; ezgitopyildiz@gmail.com.
Insights
Pediatric asthma may impact right ventricular (RV) diastolic function, even in stable cases. Two-dimensional speckle-tracking echocardiography (2D-STE) revealed preserved RV systolic mechanics but early diastolic dysfunction in asthmatic children.
Area of Science:
- Cardiology
- Pediatric Pulmonology
- Echocardiography
Background:
- Childhood asthma can lead to cardiopulmonary interactions affecting right ventricular (RV) performance.
- Subclinical myocardial dysfunction may be detected by 2D speckle-tracking echocardiography (2D-STE) beyond conventional measures.
Purpose of the Study:
- To investigate the impact of childhood asthma on RV function using 2D-STE.
- To assess RV systolic and diastolic indices in asthmatic children compared to healthy controls.
Main Methods:
- Prospective case-control study involving 70 children with asthma and 30 healthy controls (aged 6-18 years).
- Utilized standard transthoracic echocardiography, tissue Doppler imaging (TDI), and 2D-STE.
- Primary outcomes included RV global longitudinal strain (RV GLS) and strain rate; conventional RV systolic and diastolic indices were also evaluated.
Main Results:
- RV systolic mechanics were generally preserved in asthmatic children.
- No significant differences in RV GLS, RV strain rate, or TAPSE between groups.
- TDI revealed significantly lower tricuspid annular E' velocity and higher E/E' ratio in the asthma group, indicating diastolic dysfunction.
- Increased interventricular septal diastolic thickness was observed in children with asthma.
Conclusions:
- In clinically stable, mild-to-moderate pediatric asthma, RV systolic deformation assessed by 2D-STE is preserved.
- TDI-derived indices suggest early RV diastolic involvement in pediatric asthma.
- Focused assessment of RV diastolic function is crucial for identifying subclinical cardiopulmonary effects in asthmatic children.
Background:
Asthma-related cardiopulmonary interactions may affect right ventricular (RV) performance even when children are clinically stable. Two-dimensional speckle-tracking echocardiography (2D-STE) may detect subclinical myocardial dysfunction beyond conventional indices. This study aims to investigate the effects of childhood asthma on RV function by using 2D-STE.
Methods:
In this prospective case-control study, children aged 6-18 years with physician-diagnosed asthma (n = 70) and age-matched healthy controls (n = 30) underwent standard transthoracic echocardiography, tissue Doppler imaging (TDI), and 2D-STE. Primary outcomes were RV global longitudinal strain (RV GLS) and strain rate. Conventional RV systolic indices and RV diastolic indices were also assessed. Clinical characteristics and spirometry were recorded.
Results:
RV systolic mechanics were largely preserved in the asthma group. RV GLS, RV strain rate, and tricuspid annular plane systolic excursion (TAPSE) did not differ significantly between asthmatic children and controls. In contrast, tricuspid annular E' velocity was significantly lower in the asthma group (p = 0.007), and tricuspid E/E' ratio was significantly higher (p < 0.001). Interventricular septal diastolic thickness was also significantly increased among children with asthma (p = 0.027). Within the asthma cohort, TAPSE showed positive correlations with age (r = 0.478, p < 0.001), BMI (r = 0.398, p = 0.001), asthma duration (r = 0.431, p < 0.001), and FEV1 (r = 0.301, p = 0.011), whereas RV strain parameters were not significantly associated with demographic or respiratory variables.
Conclusions:
In predominantly mild-to-moderate, clinically stable pediatric asthma, RV systolic deformation by 2D-STE appears preserved, while TDI-derived indices indicate early RV diastolic involvement. Focused assessment of RV diastolic function may help to identify subclinical cardiopulmonary effects in selected children with asthma.
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Transthoracic Echocardiography (TTE)
TTE is the most common type of echocardiogram which involves placing a transducer on the patient's chest, emitting sound waves to create heart images. TTE is invaluable for evaluating the heart's size, structure, and motion, making it particularly useful for diagnosing...