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Published on: December 22, 2023
Applications of speckle tracking echocardiography in paediatric and congenital heart disease: an expert consensus
Massimiliano Cantinotti1, Tristan Ramcharan2,3, Dan Mihai Dorobantu4,5
1National Research Council, Tuscany Region Foundation G. Monasterio, Massa, Italy.
Insights
Speckle tracking echocardiography (STE) offers valuable insights into paediatric and congenital heart diseases. This guide details STE principles, applications, and limitations for improved clinical management and patient care.
Area of Science:
- Cardiology
- Medical Imaging
- Paediatric Heart Disease
Background:
- Echocardiography is crucial for diagnosing paediatric and congenital heart conditions.
- Speckle tracking echocardiography (STE) provides advanced quantitative assessment of cardiac function.
- There is a need for practical guidance on applying STE in paediatric cardiology.
Purpose of the Study:
- To provide a comprehensive guide on the application of STE in paediatric and congenital heart diseases.
- To discuss the principles, normal values, and clinical utility of STE in this population.
- To highlight limitations and encourage further research for standardized STE use.
Main Methods:
- Review of basic principles of speckle tracking echocardiography.
- Compilation of normal paediatric reference values for STE.
- Discussion of STE applications in various congenital and acquired paediatric heart diseases.
- Exploration of STE's role in patient management and follow-up with practical examples.
Main Results:
- STE offers additional insights beyond conventional echocardiographic parameters in paediatric cardiology.
- The document outlines strengths and limitations of STE in managing paediatric and congenital heart disease.
- Practical examples demonstrate STE's utility in specific clinical scenarios.
Conclusions:
- STE is a valuable tool for paediatric and congenital cardiology, offering enhanced functional assessment.
- Standardized use, further research, and multicentre studies are needed to optimize STE integration.
- This guide aims to orient clinicians and improve patient care through informed STE application.
Abstract:
This document has been developed to provide a practical guide for the application of speckle tracking echocardiography (STE) in paediatric and congenital heart diseases. In the present document, the following topics are reviewed and discussed: (i) the basic principles of STE, its potential applications, and limitations in the paediatric population; (ii) normal paediatric reference values for STE; and (iii) the use of STE in various congenital and acquired heart diseases. The potential role of routine STE in the management and follow-up of paediatric and congenital heart disease is explored, with practical examples illustrating how STE can provide additional insights beyond conventional echocardiographic parameters. Limitations regarding clinical interpretation, prognostic value, the lack of standardized timing for measurements, and the absence of universally accepted thresholds for STE-derived strain parameters are also highlighted. Overall, this document is intended to serve as a comprehensive guide to (i) orient clinicians regarding the strengths and limitations of STE in paediatric and congenital heart disease; (ii) identify specific clinical scenarios where STE may be particularly informative; and (iii) encourage future research and multicentre collaborative studies. By providing both practical guidance and a framework for further investigation, the document aims to support standardized use of STE, improve patient care, and foster the integration of this technique into routine paediatric and congenital cardiology practice.
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