What is Left Ventricular Strain in Healthy Neonates? A Systematic Review and Meta-analysis

Khan, Umael; Omdal, Tom Roar; Matre, Knut; Greve, Gottfried

doi:10.1007/s00246-019-02219-8

Cited by 15 publications

(28 citation statements)

References 55 publications

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“…This implies that the degree of smoothing sensitivity is dependent on inter-segment strain heterogeneity and base to apex gradient in strain. Meta-analyses have revealed that this varies across studies, although the general trend is a base to apex gradient of strain [ 5 , 16 ].…”

Section: Discussionmentioning

confidence: 99%

“…Although STE could potentially be very useful within neonatal cardiology, obtaining strain measurements in neonates is particularly challenging due to small heart size and high heart rates [ 4 ]. For this reason, reference values in healthy neonates have begun to emerge in recent years and are still being established [ 2 , 4 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

“…Improved quality of measurements could further enhance implementation of strain in a clinical setting. Previous studies in infants have primarily focused on the effect of vendor heterogeneity [ 6 ] or the role of user-regulated acquisition settings such as frame rate and transmitting frequency [ 5 , 7 ]. This leaves an important knowledge gap regarding the effect of user-regulated image processing settings such as spatial and temporal smoothing.…”

Section: Introductionmentioning

confidence: 99%

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Effect of Temporal and Spatial Smoothing on Speckle–Tracking-Derived Strain in Neonates

et al. 2021

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Clinical application of strain in neonates requires an understanding of which image acquisition and processing parameters affect strain values. Previous studies have examined frame rate, transmitting frequency, and vendor heterogeneity. However, there is a lack of human studies on how user-regulated spatial and temporal smoothing affect strain values in 36 neonates. This study examined nine different combinations of spatial and temporal smoothing on peak systolic left ventricular longitudinal strain in 36 healthy neonates. Strain values were acquired from four-chamber echocardiographic images in the software-defined epicardial, midwall, and endocardial layers in the six standard segments and average four-chamber stain. Strain values were compared using repeated measure ANOVAs. Overall, spatial smoothing had a larger impact than temporal smoothing, and segmental strain values were more sensitive to smoothing settings than average four-chamber strain. Apicoseptal strain decreased by approximately 4% with increasing spatial smoothing, corresponding to a 13–19% proportional change (depending on wall layer). Therefore, we recommend clinicians be mindful of smoothing settings when assessing segmental strain values.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Effect of Temporal and Spatial Smoothing on Speckle–Tracking-Derived Strain in Neonates

et al. 2021

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“…In recent years, there has been increasing interest in application of strain measurements in the neonatal population since several studies indicate that strain is often a more sensitive measure of ventricular function than conventional echocardiography [3,4]. Reference values in healthy neonates are currently being established, which will allow for the clinical assessment of pathological strain values [5,6].…”

Section: Introductionmentioning

confidence: 99%

“…The most commonly assessed systolic strain parameter is global longitudinal strain (GLS). Most pediatric studies of GLS in healthy subjects only assess GLS in the four chamber (4ch) view [6][7][8]. However, clinical guidelines recommend that strain should be derived from all three apical views, namely four chamber (4ch), three chamber (3ch) and two chamber (2ch) views [2,5].…”

Section: Introductionmentioning

confidence: 99%

Speckle tracking derived strain in neonates: planes, layers and drift

Khan

Omdal

Matre

et al. 2021

Int J Cardiovasc Imaging

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The aims of this study was to assess the effect of using a four chamber versus a three plane model on speckle tracking derived global longitudinal strain, the effects of drift compensation, the effect of assessing strain in different layers and finally the interplay between these aspects for the assessment of strain in neonates. Speckle tracking derived longitudinal strain was obtained from 22 healthy neonates. ANOVA, Bland–Altman analyses, coefficients of variation and assessment of intraclass correlation coefficients were conducted to assess the effect of the abovementioned aspects as well as assess both inter-observer and intra-observer variability. Neither the use of the three plane model versus the four chamber model nor the use of drift compensation had a substantial effect on global longitudinal strain (less than 1%, depending on which layer was being assessed). A gradient was seen with increasing strain from the epicardial to endocardial layers, similar to what is seen in older subjects. Finally, drift compensation introduced more discrepancy in segmental strain values compared to global longitudinal strain. Global longitudinal strain in healthy neonates remains reasonably consistent regardless of whether the three plane or four chamber model is used and whether drift compensation is applied. Its value increases when one moves from the endocardial to the epicardial layer. Finally, drift compensation introduces more discrepancy for regional measures of longitudinal strain compared to global longitudinal strain.

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

Sonaglioni

Nicolosi²,

Braga

et al. 2021

J of Clinical Ultrasound

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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.

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What is Left Ventricular Strain in Healthy Neonates? A Systematic Review and Meta-analysis

Cited by 15 publications

References 55 publications

Effect of Temporal and Spatial Smoothing on Speckle–Tracking-Derived Strain in Neonates

Effect of Temporal and Spatial Smoothing on Speckle–Tracking-Derived Strain in Neonates

Speckle tracking derived strain in neonates: planes, layers and drift

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

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