Postoperative assessment of left ventricular function by two-dimensional strain (speckle tracking) after paediatric cardiac surgery

Perdreau, Elodie; Séguéla, Pierre‐Emmanuel; Jalal, Zakaria; Perdreau, Adrien; Mouton, Jean-Baptiste; Nelson-Veniard, Marie; Guillet, E; Iriart, Xavier; Ouattara, Alexandre; Roubertie, François; Mauriat, Philippe; Thambo, Jean-Benoît

doi:10.1016/j.acvd.2016.03.005

Cited by 10 publications

(6 citation statements)

References 26 publications

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“…We reported a feasibility of 85-98%, which is consistent with that presented in previous studies (87-93% feasibility) [4,5]. The observed postoperative time trend of global LV strain values in our cohort is in line with previous observations [3][4][5][6]9]. Postoperatively, all LV strain parameters were constantly and significantly decreased compared to preoperative values and compared to normal pediatric subjects [10], either when expressed as absolute values or in percentiles.…”

Section: Discussionsupporting

confidence: 92%

“…There are limited data on LV STE application in pediatric cardiac surgery, deriving either from small sample sizes (<40 subjects) or retrospectively designed studies [4,6,8,9]. These studies either used small sample sizes of healthy children for comparison of strain data in CHDs with normal ranges [4,7] or did not perform a comparison with normality at all [3,5,8,9]. Regional deformation has also been poorly evaluated so far [9].…”

Section: Discussionmentioning

confidence: 99%

“…Speckle-tracking echocardiography (STE) has demonstrated significant value and an increasing impact in the evaluation of ventricular systolic function in children with congenital heart disease (CHD) [1]. STE is clinically feasible, and is more reproducible, in the assessment of left ventricular (LV) function, compared to LV ejection fraction (LVEF) [2,3]. STE strain analysis furthermore allows for a more accurate, fast, semi-automated assessment of regional ventricular function [2,3].…”

Section: Introductionmentioning

confidence: 99%

“…STE is clinically feasible, and is more reproducible, in the assessment of left ventricular (LV) function, compared to LV ejection fraction (LVEF) [2,3]. STE strain analysis furthermore allows for a more accurate, fast, semi-automated assessment of regional ventricular function [2,3]. Despite its advantages, the application of STE for the evaluation of LV function in the perioperative period of pediatric cardiac surgery has so far been limited [4][5][6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

“…Prospective studies on changes in ventricular systolic function as a function of postoperative time evaluated by STE strain analysis in pediatric cardiac surgery are currently lacking. Previous studies, furthermore, used small a sample size of healthy children (<80 subjects) [4,7] for comparison of postoperative strain values with ranges of normality, or did not perform comparisons with normal values at all [3,5,8,9]. The recent availability of nomograms for STE ventricular strain values, calculated in a large sample size (up to 721 children) covering all pediatric age groups (0-17 years) [10][11][12][13][14][15], allows for a more accurate comparison of strain values in children with CHD after surgery with an age-specific range of normality, thus enabling a better understanding of the degree of their alteration.…”

Section: Introductionmentioning

confidence: 99%

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Left Ventricular Systolic Impairment after Pediatric Cardiac Surgery Assessed by STE Analysis

et al. 2021

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Background: Speckle-tracking echocardiography (STE) has gained increasing value in the evaluation of congenital heart diseases (CHD); however, its use in pediatric cardiac surgery is limited. Aim: To evaluate left ventricular (LV) systolic impairment after biventricular pediatric cardiac surgery by STE strain (ε) analysis. Methods: We prospectively enrolled 117 children undergoing cardiac surgery for CHD. Echocardiography was performed at four different times: pre-operatively, 12–36 h (Time 1), 3–5 days (Time 2), and 6–8 days (Time 3). Images were obtained in the 4-2-and 3 apical chamber’s views to derive LV global and regional (basal/mid/apical) ε values. Results: At different postoperative times, we performed 320 examinations in 117 children (mean age: 2.4 ± 3.9, range: 0–16 years); 117 age-matched healthy children served as controls. All global, basal, and mid LVε values decreased after surgery; the lowest values being at Time 1 (p < 0.0001), which increased thereafter. At discharge, all global, basal, and mid LVε values remained lower than in pre-operative and healthy children (p < 0.05). Instead, apical segments (lowest at baseline) increased after surgery (p < 0.0001) but remained lower compared to controls. LV ejection fraction (LVEF) decreased at Time 1 (p = 0.0004) but promptly recovered to Time 2 and normalized at Time 3. Conclusions: STE ε analysis revealed a significant LV systolic impairment after surgery with amelioration thereafter but incomplete normalization at discharge. Base-apex differences emerged with apical segments that, contrary to all the other regions, showed relative hypercontractility after surgery. The slower recovery of LVε values compared to LVEF suggests that STE ε analysis may be more accurate for the follow-up of mild LV post-surgical impairment.

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