Objective: The aim of this study was to evaluate the left myocardial mechanics in pediatric heart transplant (PHT) patients after heart transplantation by three- dimensional speckle tracking echocardiography (3D-STE). Method: We retrospectively analyzed thirty-eight pediatric patient who underwent orthotopic heart transplantation from January, 2015 to December, 2021 at Union Hospital, Tongji Medical College, Huazhong University of Science and Technology. Clinical characteristics and conventional echocardiographic indices were described. 3D-STE were used to analyze myocardial mechanics in thirty-eight PHT patients. Left ventricular strain and rotational indices at 6 month and 1 year after heart transplant were obtained. Differences between left ventricular myocardial mechanic indices at 6 months and 1 year after heart transplant were analyzed and compared with normal reference range. Results: There were no statistically significant difference of LVGLS, LVGCS, LVGRS, 3D-apical peak rotation, 3D-basal peak rotation, 3D-peak twist, and 3D-peak torsion in PHT patients between 6 months and 1 year after heart transplantation( P >0.05). Compared with 3D strain normal reference, 3D-LVGLS decreased and 3D-LVGCS increased in PHT patients at 6 months after transplantation( P <0.05). Compared with 3D rotational normal reference, 3D-peak twist and 3D-peak torsion increased at 6 months after transplantation( P <0.05). Conclusion: Compared with normal reference range, strain parameters were decreased and rotational parameters were increased. The study provided evidence for further investigations in establishing normal reference range of left ventricular myocardial mechanics in PHT patients and post-transplantation management of PHT patients.

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