The clinical value of echocardiography in exploring cardiac structure and function in depressive disorder

Depression is a common mental illness worldwide and has a bidirectional relationship with cardiovascular disease. However, research on the link between adolescent depression and cardiac structure/function remains limited and partly controversial. This study aims to investigate whether depression and its severity affect cardiac structure and function in adolescents.

We enrolled 181 adolescents aged 13-19, newly diagnosed with depression at our Mental Health Center (December 2024-December 2025), and 45 healthy controls. Conventional echocardiography and two-dimensional speckle-tracking (2D- STE) assessed cardiac anatomy, systolic/diastolic function, and strain parameters. Differences between groups and correlations with depression severity were analyzed.

The depression group showed significant differences in left ventricular ejection fraction (LVEF), left ventricular fractional shortening (FS), and left ventricular end-systolic volume (LVESV) compared to controls (all p < 0.05). LVEF, FS, tricuspid annular systolic velocity (S'), E/e' ratio, and left atrial strain all correlated with depression severity (all p < 0.05). The S' values in the mild depression group were significantly higher than those in the control group, as well as those in the moderate and severe depression groups (p < 0.05). E/e' was higher in moderate depression than in mild and severe cases (p < 0.05).

Adolescents who are depressed may see changes in heart contractile function at an early period. In patients with depression, echocardiography provides a non-invasive examination of heart structure and function. It provides an image reference for real-time clinical monitoring and risk prediction by performing objective analysis using quantitative parameters.