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Chatterjee S, Mukherjee S, Rani N, Kumar P, Kumar P, Sarkar A. Assessment of cardiac function in children by strain imaging and its correlation with conventional echocardiographic parameter. Ann Card Anaesth 2022; 25:264-269. [PMID: 35799552 PMCID: PMC9387625 DOI: 10.4103/aca.aca_35_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background: The objectives of this study were to find out of normal reference value for age-dependent longitudinal strain values in children and find its correlation with conventional echocardiographic parameters. Methods: In total, 100 healthy normal children aged between 2 and 15 years were enrolled and divided into three age groups, namely, 2–5 years, 5–10 years, and 10–15 years. Using the GE Vivid 7 ultrasound platform with 4 or 7 MHz probes, both LV and RV global longitudinal strains and conventional echocardiographic parameters were acquired. Results: In normal healthy children, left ventricular GLS values were –20.10 to –19.68 (mean: –19.89), –21.93 to –21.02 (mean: –21.48), and –20.87 to –20.41 (mean: –20.64)) in children aged 2–5 years, 5–10 years, and 10–15 years and right ventricular GLS values were –16.80 to –16.44 (mean: –16.62), –27.85 to –27.27 (mean: –27.56), –28.44 to –27.93 (mean: –28.19) in the above three groups, respectively. No significant increase was noted in the left ventricular strain value from basal to the apical segment from age group 2 years to 15 years and no gender differences were seen. None of the conventional echocardiographic parameters commonly used to assess the left or right ventricular systolic function had a significant correlation with LVGLS and RVGLS. Conclusions: The mean LVGLS values were –19.89, –21.48, and –20.64 and RVGLS were –16.62, –27.56, and –28.19 in healthy normal children aged 2–5 years, 5–10 years, and 10–15 years, respectively, and conventional echocardiographic parameters did not have any significant correlation with these values.
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Affiliation(s)
- Suman Chatterjee
- Department of Cardiology, BM Birla Heart Research Centre, Kolkata, West Bengal, India
| | | | - Neha Rani
- Department of Dermatology, PMCH, Palamu, Jharkhand, India
| | - Prashant Kumar
- Department of Cardiology, RIMS, Ranchi, Jharkhand, India
| | - Prakash Kumar
- Department of Cardiology, RIMS, Ranchi, Jharkhand, India
| | - Achyut Sarkar
- Department of Cardiology, IPGMER, Kolkata, West Bengal, India
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Jashari H, Lannering K, Ibrahimi P, Djekic D, Mellander M, Rydberg A, Henein MY. Persistent reduced myocardial deformation in neonates after CoA repair. Int J Cardiol 2016; 221:886-91. [PMID: 27434366 DOI: 10.1016/j.ijcard.2016.07.114] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Accepted: 07/08/2016] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Surgical repair of coarctation of the aorta (CoA) is a safe procedure in children, however the condition is known for its potential recurrence and other related complications. The available evidence shows abnormal intrinsic properties of the aorta in CoA, thus suggesting additional effect, even after CoA repair, on left ventricular (LV) function. Accordingly, we sought to obtain a better understanding of LV myocardial mechanics in very early-corrected CoA using two-dimensional STE. METHODS AND RESULTS We retrospectively studied 21 patients with corrected CoA at a median age of 9 (2-53) days at three time points: 1) just before intervention, 2) at short-term follow-up and 3) at medium-term follow-up after intervention and compared them with normal values. Speckle tracking analysis was conducted via vendor independent software, Tomtec. After intervention, LV function significantly improved (from -12.8±3.9 to -16.7±1.7; p<0.001), however normal values were not reached even at medium term follow-up (-18.3±1.7 vs. -20±1.6; p=0.002). Medium term longitudinal strain correlated with pre intervention EF (r=0.58, p=0.006). Moreover, medium term subnormal values were more frequently associated with bicuspid aortic valve (33.3% vs. 66.6%; p<0.05). CONCLUSION LV myocardial function in neonates with CoA can be feasibly evaluated and followed up by speckle tracking echocardiography. LV subendocardial dysfunction however, remains in early infancy coarctation long after repair. Long-term follow-up through adulthood using myocardial deformation measurements should shed light on the natural history and consequences of this anomaly.
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Affiliation(s)
- Haki Jashari
- Department of Public Health and Clinical Medicine, Umeå University, Sweden
| | - Katarina Lannering
- Department of Pediatric Cardiology, Queen Silvia Children's Hospital at the Sahlgrenska University Hospital, Götenborg, Sweden
| | - Pranvera Ibrahimi
- Department of Public Health and Clinical Medicine, Umeå University, Sweden
| | - Demir Djekic
- Department of Public Health and Clinical Medicine, Umeå University, Sweden
| | - Mats Mellander
- Department of Pediatric Cardiology, Queen Silvia Children's Hospital at the Sahlgrenska University Hospital, Götenborg, Sweden
| | - Annika Rydberg
- Department of Clinical Sciences, Umeå University, Sweden
| | - Michael Y Henein
- Department of Public Health and Clinical Medicine, Umeå University, Sweden.
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Jashari H, Rydberg A, Ibrahimi P, Bajraktari G, Kryeziu L, Jashari F, Henein MY. Normal ranges of left ventricular strain in children: a meta-analysis. Cardiovasc Ultrasound 2015; 13:37. [PMID: 26250696 PMCID: PMC4528396 DOI: 10.1186/s12947-015-0029-0] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Accepted: 07/20/2015] [Indexed: 02/08/2023] Open
Abstract
AIMS The definition of normal values of two-dimensional speckle-tracking echocardiography derived left ventricular (LV) deformation parameters, is of critical importance for the routine application of this modality in children. The objectives of this study were to perform a meta-analysis of normal ranges for longitudinal, circumferential and radial strain/strain rate values and to identify confounders that may contribute to differences in reported measures. METHODS AND RESULTS A systematic search was conducted. Studies describing normal healthy subjects and observational studies that used control groups as a comparison were included. Data were combined using a random-effect model. Effects of demographic, clinical and equipment variables were assessed through meta-regression. The search identified 1,192 subjects form 28 articles. Longitudinal strain (LS) normal mean values varied from -12.9 to -26.5 (mean, -20.5; 95% CI, -20.0 to -21.0). Normal mean values of circumferential strain (CS) varied from -10.5 to -27.0 (mean, -22.06; 95% CI, -21.5 to -22.5). Radial strain (RS) normal mean values varied from 24.9 to 62.1 (mean, 45.4; 95% CI, 43.0 to 47.8). Meta-regression showed LV end diastolic diameter as a significant determinant of variation for LS. Longitudinal systolic strain rate (LSRs) was significantly determined by the age and RS by the type of vendor used. CONCLUSION Variations among different normal ranges were dependent on the vendor used, LV end-diastolic diameter and age. Vendor-independent software for analyzing myocardial deformation in children, using images from different vendors would be the ideal solution for strain measurements or else using the same system for patient's follow up.
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Affiliation(s)
- Haki Jashari
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Annika Rydberg
- Department of Clinical Sciences, Umeå University, Umeå, Sweden
| | - Pranvera Ibrahimi
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Gani Bajraktari
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Lindita Kryeziu
- Department of Neonatology, Gynecology Clinic, University Clinical Center of Kosovo, Prishtina, Kosovo
| | - Fisnik Jashari
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Michael Y Henein
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
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Oxborough D, Shave R, Warburton D, Williams K, Oxborough A, Charlesworth S, Foulds H, Hoffman MD, Birch K, George K. Dilatation and Dysfunction of the Right Ventricle Immediately After Ultraendurance Exercise. Circ Cardiovasc Imaging 2011; 4:253-63. [DOI: 10.1161/circimaging.110.961938] [Citation(s) in RCA: 121] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background—
Running an ultramarathon has been shown to have a transient negative effect on right ventricular (RV) and left ventricular (LV) function. Additionally, recent findings suggested that ultraendurance athletes may be more at risk of developing a RV cardiomyopathy. The standard echocardiographic assessment of RV function is problematic; however, the introduction of ultrasonic speckle tracking technology has the potential to yield a comprehensive evaluation of RV longitudinal function, providing new insights into this phenomenon. Thus, the primary aim of this exploratory study was to evaluate comprehensively RV structure and function after a 161-km ultramarathon and establish whether changes in the RV are associated with alterations in LV function.
Methods and Results—
Myocardial speckle tracking echocardiograms of the RV and LV were obtained before and immediately after a 161-km ultramarathon in 16 healthy adults. Standard echocardiography was used to determine RV size and function and LV eccentricity index. Speckle tracking was used to determine the temporal evaluation of indices of RV and LV function. RV size was significantly increased postrace (RV outflow, 32 to 35 mm,
P
=0.002; RV inflow, 42 to 45 mm,
P
=0.027) with an increase in LV eccentricity index (1.03 to 1.13,
P
=0.006). RV strain (ε) was significantly reduced postrace (−27% to −24%,
P
=0.004), but there was no change in the rates of ε. Peak ε in all planes of LV motion were reduced postrace (longitudinal, −18.3 to −16.3%,
P
=0.012; circumferential, −20.2% to −15.7%,
P
=0.001; radial, 53.4% to 40.3%,
P
=0.009). Changes in RV size and function correlated with diastolic strain rates in the LV.
Conclusions—
This exploratory study demonstrates RV dilatation and reduction in function after an ultramarathon. Further research is warranted to elucidate the mechanisms responsible for these findings. It is not clear what clinical impact might result from consecutive bouts of postexercise RV dysfunction.
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Affiliation(s)
- David Oxborough
- From the Faculty of Medicine and Health, University of Leeds, Leeds, UK (D.O.); Cardiff School of Sport, Cyncoed Campus, Cyncoed, Cardiff, Wales, UK (R.S.); Centre for Sport Medicine and Human Performance, Brunel University, Uxbridge, London, UK (R.S.); Cardiovascular Physiology and Rehabilitation Laboratory, Physical Activity and Chronic Disease Prevention Unit and Experimental Medicine Program, University of British Columbia, Vancouver, British Columbia, Canada (D.W., S.C., H.F.); Research
| | - Robert Shave
- From the Faculty of Medicine and Health, University of Leeds, Leeds, UK (D.O.); Cardiff School of Sport, Cyncoed Campus, Cyncoed, Cardiff, Wales, UK (R.S.); Centre for Sport Medicine and Human Performance, Brunel University, Uxbridge, London, UK (R.S.); Cardiovascular Physiology and Rehabilitation Laboratory, Physical Activity and Chronic Disease Prevention Unit and Experimental Medicine Program, University of British Columbia, Vancouver, British Columbia, Canada (D.W., S.C., H.F.); Research
| | - Darren Warburton
- From the Faculty of Medicine and Health, University of Leeds, Leeds, UK (D.O.); Cardiff School of Sport, Cyncoed Campus, Cyncoed, Cardiff, Wales, UK (R.S.); Centre for Sport Medicine and Human Performance, Brunel University, Uxbridge, London, UK (R.S.); Cardiovascular Physiology and Rehabilitation Laboratory, Physical Activity and Chronic Disease Prevention Unit and Experimental Medicine Program, University of British Columbia, Vancouver, British Columbia, Canada (D.W., S.C., H.F.); Research
| | - Karen Williams
- From the Faculty of Medicine and Health, University of Leeds, Leeds, UK (D.O.); Cardiff School of Sport, Cyncoed Campus, Cyncoed, Cardiff, Wales, UK (R.S.); Centre for Sport Medicine and Human Performance, Brunel University, Uxbridge, London, UK (R.S.); Cardiovascular Physiology and Rehabilitation Laboratory, Physical Activity and Chronic Disease Prevention Unit and Experimental Medicine Program, University of British Columbia, Vancouver, British Columbia, Canada (D.W., S.C., H.F.); Research
| | - Adele Oxborough
- From the Faculty of Medicine and Health, University of Leeds, Leeds, UK (D.O.); Cardiff School of Sport, Cyncoed Campus, Cyncoed, Cardiff, Wales, UK (R.S.); Centre for Sport Medicine and Human Performance, Brunel University, Uxbridge, London, UK (R.S.); Cardiovascular Physiology and Rehabilitation Laboratory, Physical Activity and Chronic Disease Prevention Unit and Experimental Medicine Program, University of British Columbia, Vancouver, British Columbia, Canada (D.W., S.C., H.F.); Research
| | - Sarah Charlesworth
- From the Faculty of Medicine and Health, University of Leeds, Leeds, UK (D.O.); Cardiff School of Sport, Cyncoed Campus, Cyncoed, Cardiff, Wales, UK (R.S.); Centre for Sport Medicine and Human Performance, Brunel University, Uxbridge, London, UK (R.S.); Cardiovascular Physiology and Rehabilitation Laboratory, Physical Activity and Chronic Disease Prevention Unit and Experimental Medicine Program, University of British Columbia, Vancouver, British Columbia, Canada (D.W., S.C., H.F.); Research
| | - Heather Foulds
- From the Faculty of Medicine and Health, University of Leeds, Leeds, UK (D.O.); Cardiff School of Sport, Cyncoed Campus, Cyncoed, Cardiff, Wales, UK (R.S.); Centre for Sport Medicine and Human Performance, Brunel University, Uxbridge, London, UK (R.S.); Cardiovascular Physiology and Rehabilitation Laboratory, Physical Activity and Chronic Disease Prevention Unit and Experimental Medicine Program, University of British Columbia, Vancouver, British Columbia, Canada (D.W., S.C., H.F.); Research
| | - Martin D. Hoffman
- From the Faculty of Medicine and Health, University of Leeds, Leeds, UK (D.O.); Cardiff School of Sport, Cyncoed Campus, Cyncoed, Cardiff, Wales, UK (R.S.); Centre for Sport Medicine and Human Performance, Brunel University, Uxbridge, London, UK (R.S.); Cardiovascular Physiology and Rehabilitation Laboratory, Physical Activity and Chronic Disease Prevention Unit and Experimental Medicine Program, University of British Columbia, Vancouver, British Columbia, Canada (D.W., S.C., H.F.); Research
| | - Karen Birch
- From the Faculty of Medicine and Health, University of Leeds, Leeds, UK (D.O.); Cardiff School of Sport, Cyncoed Campus, Cyncoed, Cardiff, Wales, UK (R.S.); Centre for Sport Medicine and Human Performance, Brunel University, Uxbridge, London, UK (R.S.); Cardiovascular Physiology and Rehabilitation Laboratory, Physical Activity and Chronic Disease Prevention Unit and Experimental Medicine Program, University of British Columbia, Vancouver, British Columbia, Canada (D.W., S.C., H.F.); Research
| | - Keith George
- From the Faculty of Medicine and Health, University of Leeds, Leeds, UK (D.O.); Cardiff School of Sport, Cyncoed Campus, Cyncoed, Cardiff, Wales, UK (R.S.); Centre for Sport Medicine and Human Performance, Brunel University, Uxbridge, London, UK (R.S.); Cardiovascular Physiology and Rehabilitation Laboratory, Physical Activity and Chronic Disease Prevention Unit and Experimental Medicine Program, University of British Columbia, Vancouver, British Columbia, Canada (D.W., S.C., H.F.); Research
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