Does chest wall conformation influence myocardial strain parameters in infants with pectus excavatum?

Abstract

Purpose To investigate the possible influence of chest wall conformation on myocardial strain parameters in a consecutive population of infants with pectus excavatum (PE), noninvasively assessed by modified Haller index (MHI). Methods Sixteen consecutive PE infants (MHI >2.5) and 44 infants with normal chest shape (MHI ≤2.5) entered in this prospective case–control study. All infants underwent evaluation by neonatologist, transthoracic echocardiography implemented with two‐dimensional speckle tracking echocardiography (2D‐STE) analysis of both ventricles and MHI assessment (ratio of chest transverse diameter over the distance between sternum and spine), at two time points: within 3 days and at about 40 days of life. Results At 2.1 ± 1 days of life, compared to controls (MHI = 2.01 ± 0.2), PE infants (MHI = 2.76 ± 0.2) were diagnosed with significantly smaller cardiac chambers dimensions. Biventricular contractile function and hemodynamics were similar in both groups of infants. Left ventricular (LV) global longitudinal strain (GLS) (−16.0 ± 2.8 vs. −21.7 ± 2.2%), LV‐global circumferential strain (GCS) (−16.3 ± 2.7 vs. −24.0 ± 5.2%), LV‐global radial strain (GRS) (24.2 ± 3.0 vs. 31.5 ± 6.3%), and right ventricular free wall longitudinal strain (RVFWLS) (−16.0 ± 3.2 vs. −22.3 ± 4.4%) were significantly reduced in PE infants versus controls (all p < 0.001). A strong inverse correlation between MHI and the following parameters: LV‐GLS (r = −0.92), LV‐GCS (r = −0.88), LV‐GRS (r = −0.87), and RVFWLS (r = −0.88), was demonstrated in PE infants, but not in controls, in perinatal period (all p < 0.001). Analogous results were obtained at 36.8 ± 5.2 days after birth. Conclusions Abnormal chest anatomy progressively impairs myocardial strain parameters in PE infants. This impairment might reflect intraventricular dyssynchrony due to compressive phenomena rather than intrinsic myocardial dysfunction.

Subjects Conceived through Assisted Reproductive Technologies Display Normal Arterial Stiffness

“…Further, the potential influence of extrinsic mechanical factors (e.g., chest wall conformation) on arterial elastance and ventricular–arterial coupling needs to be addressed and investigated in further studies [ 59 , 60 ].…”

Molecular Approaches and Echocardiographic Deformation Imaging in Detecting Myocardial Fibrosis

“…Both diameters are measured at the end of inspiration. An increased MHI, due to a narrow A-P chest diameter, was found to be the main anthropometric determinant of the significant reduction in myocardial deformation indices, particularly at the level of basal segments, detected in healthy individuals with a concave-shaped chest wall and/or pectus excavatum (PE) (as noninvasively defined by a MHI > 2.5) [144], in absence of any intrinsic myocardial dysfunction [145][146][147][148][149]. Moreover, individuals with MHI > 2.5 have been found to receive excellent prognoses over mid-to-long term follow-up [150][151][152].…”

Echocardiographic evaluation of myocardial strain in bipolar disorder across different phases: A comparative study with healthy controls

“…These considerations underscore the importance of accounting for physical factors that could influence cardiac imaging results. [15] Although the study offers novel insights, it is not without limitations. The cross-sectional design restricts our ability to establish causality.…”

“…These considerations underscore the importance of accounting for physical factors that could influence cardiac imaging results. [15]…”