Reference Values for Myocardial Two-Dimensional Strain Echocardiography in a Healthy Pediatric and Young Adult Cohort

Marcus, Karen A.; Mavinkurve‐Groothuis, Annelies M. C.; Barends, Marlieke; Dijk, Arie P.J. van; Feuth, Ton; Korte, Chris L. de; Kapusta, Livia

doi:10.1016/j.echo.2011.01.021

Cited by 178 publications

(173 citation statements)

References 41 publications

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“…Even in normal seg- ments, SI measurements are heterogeneous among various LV segments. 15) Thus, we believe that the cutoff values of SI-DI for detecting CAD should be examined in each individual segment, as was done in this study. Limitations: First, although we excluded patients with diseases which could affect wall motion, there may still be some latent factors, such as diabetes or hypertension, which can affect left ventricular diastolic function.…”

Section: Discussionmentioning

confidence: 99%

“…Even normal SI measurements are heterogeneous among different LV segments. 15) We hypothesized that the optimal cutoff values of SI-DI for detecting significant coronary artery stenosis might be different among each LV segment, and SIDI is useful for detecting CAD even in patients without RWMA. The aim of the present study was to determine whether segmental analysis of abnormal regional LV relaxation by transverse SI-DI at rest could predict coronary artery stenosis and its culprit lesion anatomy in the three major vessels in patients without RWMA.…”

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confidence: 99%

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Prediction of Coronary Artery Stenosis at Rest in Patients With Normal Left Ventricular Wall Motion

et al. 2013

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SummaryNoninvasive detection of coronary artery stenosis usually requires a stress test in patients without left ventricular (LV) regional wall motion abnormalities (RWMA). In contrast, abnormal regional LV relaxation caused by ischemia may persist beyond recovery from transient ischemia. The aim of the present study was to determine whether segmental analysis of abnormal regional LV relaxation using the strain imaging diastolic index (SI-DI) at rest could predict coronary artery stenosis in the three major vessels in patients without LV dysfunction or RWMA. We performed 2D speckle tracking echocardiography and coronary angiography in 85 patients without RWMA with suspected coronary artery disease. Patients with LV dysfunction or acute coronary syndrome were excluded. Echocardiographic images of the LV were obtained in the apical 2-, 3-, and 4-chamber views and divided into 6 segments. In each segment, SI-DI derived from transverse strain imaging was determined. Forty-eight patients had significant coronary artery stenosis (≥ 70%). The optimal cutoff values of SI-DI were 60.5% in the mid anteroseptal segment for detecting left anterior descending artery stenosis (sensitivity, 83.3%; specificity, 81.1%), 60.5% in the basal anterolateral segment for detecting left circumflex artery stenosis (sensitivity, 80.9%; specificity, 90.3%), and 61.5% in the basal inferior segment for detecting right coronary artery stenosis (sensitivity, 74.1%; specificity, 77.8%). A segmental analysis of SI-DI at rest predicted coronary artery stenosis in the three major vessels in patients without RWMA. This noninvasive method may be useful for detecting coronary artery stenosis without a stress test. (Int Heart J 2013; 54: 266-272)

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Section: Discussionmentioning

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Prediction of Coronary Artery Stenosis at Rest in Patients With Normal Left Ventricular Wall Motion

et al. 2013

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“…Currently, myocardial strain measurement by 2-D speckle tracking has only been used in children in one previous pilot study to assess myocardial function during exercise (4). Two-dimensional strain measurement has been validated in clinical pediatric echocardiography for the assessment of left ventricular (LV) and right ventricular (RV) function (12), at rest in normative healthy pediatric volunteers (28), and has been validated against magnetic resonance imaging (20). The correlation of 2-D strain to invasive contractility measurements has been shown in the animal model (21).…”

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The relationship between biventricular myocardial performance and metabolic parameters during incremental exercise and recovery in healthy adolescents

Pieles¹,

Gowing

Forsey

et al. 2015

American Journal of Physiology-Heart and Circulatory Physiology

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Pieles GE, Gowing L, Forsey J, Ramanujam P, Miller F, Stuart AG, Williams CA. The relationship between biventricular myocardial performance and metabolic parameters during incremental exercise and recovery in healthy adolescents. Am J Physiol Heart Circ Physiol 309: H2067-H2076, 2015. First published October 23, 2015 doi:10.1152/ajpheart.00627.2015 and right ventricular (RV) myocardial reserve during exercise in adolescents has not been directly characterized. The aim of this study was to quantify myocardial performance response to exercise by using two-dimensional (2-D) speckle tracking echocardiography and describe the relationship between myocardial reserve, respiratory, and metabolic exercise parameters. A total of 23 healthy boys and girls (mean age 13.2 Ϯ 2.7 yr; stature 159.1 Ϯ 16.4 cm; body mass 49.5 Ϯ 16.6 kg; BSA 1.47 Ϯ 0.33 m 2 ) completed an incremental cardiopulmonary exercise test (25 W·3 min increments) with simultaneous acquisition of 2-D transthoracic echocardiography at rest, each exercise stage up to 100 W, and in recovery at 2 min and 10 min. Two-dimensional LV (LV Sl) and RV (RV Sl) longitudinal strain and LV circumferential strain (LV Sc) were analyzed to define the relationship between myocardial performance reserve and metabolic exercise parameters. Participants achieved a peak oxygen uptake (V O2peak) of 40.6 Ϯ 8.9 ml·kg Ϫ1 ·min Ϫ1 and a work rate of 154 Ϯ 42 W. LV Sl and LV Sc and RV Sl increased significantly across work rates (P Ͻ 0.05). LV Sl during exercise was significantly correlated to resting strain, V O2peak, oxygen pulse, and work rate (0.530 Յ r Յ 0.784, P Ͻ 0.05). This study identifies a positive and moderate relationship between LV and RV myocardial performance and metabolic parameters during exercise by using a novel methodology. Relationships detected present novel data directly describing myocardial adaptation at different stages of exercise and recovery that in the future can help directly assess cardiac reserve in patients with cardiac pathology. CARDIOVASCULAR EXERCISE RESPONSE is a complex interplay between respiratory, metabolic, cardiac, and muscular adaptations and is traditionally assessed in children by using cardiopulmonary exercise testing (CPET) (1, 34). CPET has been used in diagnosis and risk stratification in children with heart disease (38) as it can impose physiological stress on the cardiovascular system to determine submaximal and maximal capacity, while numerous studies in adults with cardiovascular disease have shown CPET is a strong predictor of clinical outcome (2). Two methodological limitations of CPET are, however, the inability to provide data on myocardial function in response to the imposed exercise stress, the dominant process being to increase cardiac output to enhance oxygen delivery (3), and its limited and indirect inferences of cardiac reserve.Over the last decade these methodological constraints have led to several pilot studies directly investigating cardiac function during exercise in the healthy pediatric population by using echoca...

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“…La medición de la función ventricular utilizando la ecocardiografía con ST, a juzgar por el número de publicaciones, es cada vez más frecuente y aunque la mayoría de ellas se haya realizado sobre población adulta, en los últimos años han aparecido trabajos en cardiología pediátrica 17,18,19 que dan cuenta de la importancia de esta nueva técnica sobre la evaluación de la función miocárdica en este grupo poblacional por lo que consideramos de gran importancia obtener valores referenciales propios.…”

Section: Discussionunclassified

“…17 De los diferentes segmentos de cada pared, los mayores valores de strain miocárdico se presentaron en los segmentos apicales, luego los segmentos medios y los valores menores se obtuvieron en los segmentos basales, de manera tal que la deformidad miocárdica se incrementa de base a ápex, hallazgo similar al reportado por otros investigadores. 10,17 Al observar que las mayores cifras de deformidad pico sistólica con relación a los grupos etarios se encontraron entre los niños de 10 a 13 años, se cree que estos hallazgos están muy probablemente en relación con cambios corporales que se producen con el crecimiento. Estos cambios, que para algunos autores reflejaría un proceso natural de maduración miocárdica, 20,21 no han sido encontrados en otras investigaciones.…”

Section: Discussionunclassified

Estudio de la función miocárdica mediante ecocardiografía con Speckle-Tracking valores normales en una población pediátrica

Alemán

Barrezueta

2015

Rev. Med. UCSG

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ResumenObjetivo: estudiar la deformación miocárdica mediante ecocardiografía con speckle tracking y estimar los valores normales del strain sistólico longitudinal en una población pediátrica sana. Materiales y métodos: se revisaron 100 estudios ecocardiográficos en niños normales con edades entre 5 y 18 años midiendo los valores de la deformación pico sistólica longitudinal, el análisis estadístico usado fue ANOVA. Resultados: la deformación miocárdica longitudinal global promedio fue -22,17 % +-0,39. El grupo que mayor deformación presentó fue el de 10-13 años (-22,62 % +-1,86) p< 0.002 y entre los segmentos de pared, los apicales (-22,86 +-0,70) p<0.005 fueron los que mayor valor alcanzaron. Conclusiones: el estudio establece nuestros valores referenciales de deformación miocárdica longitudinal mediante ecocardiografía con speckle tracking. Los resultados son similares a los publicados por otros autores.PALABRAS CLAVE: ecocardiografía, contracción miocárdica, pediatría. Abstract Objective: to study myocardial deformation using speckle tracking echocardiography and estimating the normal values of longitudinal systolic strain in a healthy pediatric population. Method: 100 echocardiographic studies were reviewed in normal children aged between 5 and 18 measuring the values of peak systolic longitudinal strain. The statistical analysis used was ANOVA. Results: global longitudinal myocardial deformation average was -22.17% + -0.39. The group that presented the greatest deformation was the 10-13 year old children (-22.62% + -1.86) p <0.002 and between the wall segments, the apical (-22.86 + -0.70) p < 0,005 reached the highest value. Conclusions: the study establishes our reference values for longitudinal myocardial deformation using speckle tracking echocardiography. The results are similar to those published by other authors. KEYWORDS: echocardiography, myocardial contraction, pediatrics.Resumo Objetivo: estudo de deformação do miocárdio pela ecocardiografia com speckle tracking e estimação dos valores normais da tensão sistólica longitudinal em uma população pediátrica saudável. Método: foram revisados 100 estudos ecocardiográficos em crianças normais com idades entre 5 e 18 anos medindo os valores da deformação do pico sistólico longitudinal, a análise estatística utilizada foi a ANOVA. Resultados: a média global de deformação longitudinal do miocárdio foi -22,17 % +-0,39. O grupo que apresentou maior deformação foi o de 10-13 anos (-22,62 % +-1,86) p< 0,002 e entre os segmentos da parede, os apicais (-22,86 +-0,70) p<0,005 foram aqueles com o maior valor. Conclusões: o estudo estabelece os nossos valores de referência de deformação longitudinal do miocárdio pela ecocardiografia com speckle tracking. Os resultados são similares aos publicados por outros autores.PALABRAS-CHAVE: ecocardiografia, contração miocárdica, pediatria.

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Reference Values for Myocardial Two-Dimensional Strain Echocardiography in a Healthy Pediatric and Young Adult Cohort

Cited by 178 publications

References 41 publications

Prediction of Coronary Artery Stenosis at Rest in Patients With Normal Left Ventricular Wall Motion

Prediction of Coronary Artery Stenosis at Rest in Patients With Normal Left Ventricular Wall Motion

The relationship between biventricular myocardial performance and metabolic parameters during incremental exercise and recovery in healthy adolescents

Estudio de la función miocárdica mediante ecocardiografía con Speckle-Tracking valores normales en una población pediátrica

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