Left ventricular longitudinal strain measured by speckle tracking as a predictor of the decrease in left ventricular deformation in children with congenital stenosis of the aorta or coarctation of the aorta.

Abstract

Children born with a left ventricular outflow tract obstruction (LVOTO) can present with symptoms of left ventricular (LV) failure while ejection fraction (EF) is normal. A more sensitive parameter of systolic function might be obtained with speckle tracking echocardiography, which describes ventricular longitudinal deformation in strain values. It is presumed that despite a normal or only slight decrease in ejection fraction, patients with a LVOTO demonstrate aberrations in the longitudinal deformation of the left ventricle. In addition, it is expected that after a successful intervention, longitudinal deformation returns to normal values. Standard trans-thoracic echocardiography was performed on 33 consecutive patients with a LVOTO, either an isolated aortic coarctation (AoCo) or an isolated aortic stenosis (AoSt). Before intervention a significant decrease in strain values was observed compared with the control group (N = 40), with an additional decrease in strain values in the first week after intervention (N = 16). Strain values recovered after a mean follow-up period of 42 wk (N = 9), though normal values were never reached. In addition, patients with an AoCo had a smaller decrease in strain values compared with patients with AoSt. All strain values were measured with a concomitant ejection fraction between normal limits. It is concluded that patients with a congenital LVOTO have decreased ventricular systolic function measured as strain values, whereas their ejection fraction is within the normal range. Therefore, as ejection fraction may not be an accurate measure, speckle tracking-based strain may be significant in the identification of subtle changes in longitudinal deformation and may create opportunities for patients to benefit from early treatment for heart failure.

• Authors: J Van der Ende, Clara A Vázquez Antona, Julio Erdmenger Orellana, Ángel Romero Cárdenas, Francisco Javier Roldan, Jesús Vargas Barrón
• Journal: Ultrasound in medicine & biology (Ultrasound Med Biol) Vol. 39 Issue 7 Pg. 1207-14 (Jul 2013) ISSN: 1879-291X [Electronic] England
• PMID: 23643058 (Publication Type: Journal Article)
• Copyright: Copyright © 2013 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

Topics

• Aortic Coarctation (complications, diagnostic imaging)
• Aortic Valve Stenosis (complications, diagnostic imaging)
• Child
• Echocardiography (methods)
• Elasticity Imaging Techniques (methods)
• Female
• Humans
• Male
• Prognosis
• Reproducibility of Results
• Sensitivity and Specificity
• Stroke Volume
• Ventricular Outflow Obstruction (diagnostic imaging, etiology)