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Reference values for two-dimensional myocardial strain echocardiography of the left ventricle in healthy children

Published online by Cambridge University Press:  19 February 2019

Laurens P. Koopman ,
Bas Rebel ,
Devi Gnanam ,
Mirthe E. Menting ,
Willem A. Helbing  and
Eric Boersma
Laurens P. Koopman*
Affiliation:
Department of Pediatrics, Division of Pediatric Cardiology, Erasmus Medical Centre, Sophia Children’s Hospital, Rotterdam, The Netherlands
Bas Rebel
Affiliation:
Department of Pediatrics, Division of Pediatric Cardiology, Erasmus Medical Centre, Sophia Children’s Hospital, Rotterdam, The Netherlands
Devi Gnanam
Affiliation:
Department of Pediatrics, Division of Pediatric Cardiology, Erasmus Medical Centre, Sophia Children’s Hospital, Rotterdam, The Netherlands
Mirthe E. Menting
Affiliation:
Department of Cardiology, Erasmus Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
Willem A. Helbing
Affiliation:
Department of Pediatrics, Division of Pediatric Cardiology, Erasmus Medical Centre, Sophia Children’s Hospital, Rotterdam, The Netherlands
Eric Boersma
Affiliation:
Department of Cardiology, Erasmus Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
*
Author for correspondence: Laurens P. Koopman, E-mail: l.koopman@erasmusmc.nl
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Abstract

Background

Myocardial deformation by speckle tracking echocardiography provides additional information on left ventricular function. Values of myocardial deformation (strain and strain rate) depend on the type of ultrasound machine and software that is used. Normative values for QLAB (Philips) are scarce, especially for children. It is important to evaluate the influence of age and body size on myocardial deformation parameters, since anthropometrics strongly influence many standard echocardiographic parameters. The aim of this study was to provide comprehensive normal values for myocardial deformation of the left ventricle using a Philips platform and to evaluate the association with anthropometric and standard echocardiographic parameters.

Methods

Healthy children between 1 and 18 years of age were prospectively examined using a standard echocardiographic protocol. Short-axis and apical four-chamber, two-chamber, and three-chamber views were used to measure peak systolic circumferential and longitudinal strain and systolic and early diastolic strain rate of the left ventricle using dedicated software.

Results

A total of 103 children were included with a mean age of 10.8 and inter-quartile range 7.3–14.3 years. Global circumferential strain values (±SD) were −24.2±3.5% at basal, −25.8±3.5% at papillary muscle, and −31.9±6.2% at apex levels. Global left ventricular longitudinal strain values were −20.6±2.6% in apical four-chamber view, −20.9±2.7% in apical two-chamber, and −21.0 ±2.7% in apical three-chamber. Age was associated with longitudinal strain, longitudinal systolic and early diastolic strain rate, but not with circumferential strain.

Conclusions

Normal values for left ventricular deformation parameters in children are obtained using a Philips platform. Age partly explains normal variation of strain and strain rate.

Keywords

Reference valuesspeckle tracking echocardiographychildren
Type
Original Article
Information
Cardiology in the Young , Volume 29 , Issue 3 , March 2019 , pp. 325 - 337
Copyright
© Cambridge University Press 2019 

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Footnotes

Cite this article: Koopman LP, Rebel B, Gnanam D, Menting ME, Helbing WA, Boersma E. (2019) Reference values for two-dimensional myocardial strain echocardiography of the left ventricle in healthy children. Cardiology in the Young29: 325–337. doi: 10.1017/S1047951118002378

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