Reference Values for Two-Dimensional Speckle Tracking Echocardiography in Normal Healthy Children

Abstract

One of the earliest applications of clinical echocardiography was the evaluation of left ventricular (LV) size and function. The accuracy of the determination of global and regional LV function with echocardiography has improved as the technology has matured (Picard et al., 2008). Although conventional echocardiography is considered to be reliable for ventricular wall motion analysis and assessment of regional myocardial function, the visual estimation of wall motion is very subjective and therefore highly operator dependent. It also has high interobserver and intraobserver variability and allows only limited evaluation of radial displacement and deformation, without the possibility of assessing myocardial shortening and twisting (Perk et al.,2007). During recent years, velocity imaging, displacement imaging and deformation imaging (strain and strain-rate imaging) have emerged as valuable tools for more comprehensive and reliable echocardiographic assessment of myocardial function (Yu et al., 2007). Initially myocardial deformation imaging became possible using tissue Doppler. More recently myocardial deformation imaging also become possible with myocardial speckle tracking using 2D echocardiography( Dandel et al., 2009). Speckle-tracking echocardiography is a new non-invasive ultrasound imaging technique that allows for an objective and quantitative evaluation of global and regional myocardial function independently of the angle of insonation and the cardiac translational movements (Blessberger et al., 2010 & Sergio et al., 2011). The aim of this study was to evaluate the global and regional left ventricular longitudinal systolic strain by 2D STE in a large group of healthy children across a wide age range to establish their reference values and to assess the influence of age, sex and hemodynamic factors. This study was conducted at the Echocardiography Unit, Pediatric Department at Ain Shams University, over the period from November 2013 to February 2015 on 250 healthy children without any known cardiovascular diseases.

All children were subjectedtodetailed history takinglaying stress onpast medical history of clinical significance, family history of cardiovascular diseases in an early age and symptoms suggestive of any cardiovasculardiseases.