Cyclic variation of integrated ultrasound backscatter: normal and abnormal myocardial patterns in children

Area of Science:

• Pediatric Cardiology
• Diagnostic Ultrasound
• Biomedical Engineering

Background:

• Cyclic variation of integrated backscatter (CVIBS) is an established echocardiographic parameter in adults.
• Altered CVIBS is observed in adults with conditions like myocardial infarction, allograft rejection, and cardiomyopathy.
• The diagnostic utility of CVIBS in pediatric populations has not been previously established.

Purpose of the Study:

• To investigate the feasibility and diagnostic value of CVIBS in a pediatric cohort.
• To establish normal CVIBS values across different pediatric age groups, including fetuses, newborns, children, and teenagers.
• To determine if CVIBS is altered in children diagnosed with cardiomyopathy.

Main Methods:

• A cohort of 99 normal subjects (16 fetuses, 13 newborns, 47 children, 23 teenagers) and 15 children with cardiomyopathy were studied.
• CVIBS was measured using a 2D ultrasound system with acoustic densitometry software.
• Measurements were taken from the anterior septum and left ventricular posterior wall.

Main Results:

• Normal CVIBS values were similar between the anterior septum and posterior wall in healthy children post-birth.
• Fetal CVIBS was significantly lower than in newborns and children.
• Children with cardiomyopathy exhibited significantly diminished CVIBS compared to healthy controls, irrespective of cardiomyopathy type (dilated or infiltrative).
• Four children showed persistently diminished CVIBS post-recovery from cardiomyopathy, despite normalized systolic function.

Conclusions:

• The pattern and extent of CVIBS in children are comparable to those observed in adults.
• CVIBS is a sensitive indicator of myocardial dysfunction in pediatric cardiomyopathy.
• Diminished CVIBS may persist even after clinical recovery from cardiomyopathy in children.