scholarly journals Correlations between Left Ventricular and Left Atrial Function Assessed by Speckle Tracking Echocardiography in Patients with Treated Well-Controlled Arterial Hypertension

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Beata Uziębło-Życzkowska ◽  
Paweł Krzesiński
Keyword(s):  
Arterial Hypertension ◽  
Diastolic Function ◽  
Left Atrial ◽  
Speckle Tracking ◽  
Longitudinal Strain ◽  
Speckle Tracking Echocardiography ◽  
Left Ventricular ◽  
Absolute Value ◽  
The Absolute ◽  
Lv Diastolic Function

Introduction. Even in patients with well-controlled arterial hypertension (AH) and without significant comorbidities, left ventricular (LV) and left atrial (LA) strain abnormalities may sometimes be found in speckle-tracking echocardiography. Therefore, the aim of this study was to investigate the correlation between LA strain and LV diastolic and systolic function in a group of patients with treated, well-controlled AH. Material and methods. LA contractile, conduit, and reservoir function, together with echocardiographic signs of LV diastolic function and LV global longitudinal strain (LV GLS), were assessed in 101 patients with treated, well-controlled AH who met the standard criteria of normal LV ejection fraction (LVEF) and normal LV diastolic function. Results. A relevant percentage of study participants presented lower than reference LV (−18.7% for LV GLS) and LA strain (32.9% for LAS during reservoir phase, LASr; −15.9% for LAS during contraction phase, LASct; and −13.9% for LAS during conduit phase, LAScd) values. Moreover, there were statistically significant differences in LA longitudinal strain (LAS) values (LASr (31.43 vs. 36.33; p  = 0.0007) and LAS LAScd (−13.09 vs. −15.79; p  = 0.008)) between patients with high (>the absolute value of −20%) and lower (≤the absolute value of −20%) LV GLS, confirmed by significant correlations between LASr, LAScd, and GLS. In the correlations analysis between LAS values and LV diastolic function parameters, statistical significance was obtained for the following: LASct (contraction) versus e’avg, LASct versus E/A, LASct versus A, LAScd versus e’avg, LAScd versus E/A, and LAScd versus A. Conclusions. LV and LA strain abnormalities occurred within a significant percentage of patients with treated, well-controlled AH. Impaired LA strain is associated with lower LV strain and reduced LV diastolic function parameters, reflecting both the passive and active properties of the LA.

scholarly journals Correlations between left ventricular and left atrial function assessed by speckle tracking echocardiography in patients with treated well-controlled arterial hypertension

2020 ◽  
Author(s):  
Beata Uziebło-Życzkowska ◽  
Paweł Krzesiński
Keyword(s):  
Arterial Hypertension ◽  
Diastolic Function ◽  
Left Atrial ◽  
Speckle Tracking ◽  
Longitudinal Strain ◽  
Speckle Tracking Echocardiography ◽  
Statistical Significance ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
Lv Diastolic Function

Abstract BackgroundEven in patients with well-controlled arterial hypertension (AH) and without significant comorbidities left ventricular (LV) and left atrial (LA) strain abnormalities may sometimes be found in speckle-tracking echocardiography. Therefore, the aim of this study was to investigate the correlation between LA strain and LV diastolic and systolic function in a group of patients with treated, well-controlled AH.Methods LA contractile, conduit, and reservoir function, together with echocardiographic signs of LV diastolic function and LV global longitudinal strain (LV GLS), were assessed in 101 patients with treated, well-controlled AH who met the standard criteria of normal LV ejection fraction (LVEF) and normal LV diastolic function.ResultA relevant percentage of study participants presented lower than reference LV and LA strain values. Moreover, there were statistically significant differences in LA longitudinal strain (LAS) values (LAS during reservoir phase—LASr (p<0.001) and LAS during conduit phase—LAScd (p = 0.008)) between patients with high and lower LV GLS, confirmed by significant correlations between LASr, LAScd, and GLS. In the correlations analysis between LAS values and LV diastolic function parameters, statistical significance was obtained for the following: LASct (contraction) vs. e’avg, LASct vs. E/A, LASct vs. A, LAScd vs. e’avg, LAScd vs. E/A, and LAScd vs. A. Conclusions LV and LA strain abnormalities occurred within a significant percentage of patients with treated, well-controlledAH. Impaired LA strain is associated with lower LV strain and reduced LV diastolic function parameters, reflecting both the passive and active properties of the LA.

P4351Validation by cardiac catheterization of noninvasive evaluation of left ventricular chamber and myocardial stiffness as a diastolic function using speckle tracking echocardiography

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
T Yoshizane ◽  
R Tanaka ◽  
M Kawasaki ◽  
M Otsuka ◽  
T Shoji ◽  
...  
Keyword(s):  
Diastolic Function ◽  
Cardiac Catheterization ◽  
Left Atrial ◽  
Speckle Tracking ◽  
Speckle Tracking Echocardiography ◽  
Diastolic Pressure ◽  
Hypertensive Heart Disease ◽  
Left Ventricular ◽  
Minimum Volume ◽  
Myocardial Stiffness

Abstract Background Left ventricular (LV) diastolic function is mainly composed of LV relaxation and LV stiffness. We reported that pulmonary capillary wedge pressure (ePCWP) and LV relaxation assessed by Tau (eTau) are noninvasively evaluated by speckle tracking echocardiography (STE). The minimum LV diastolic pressure (mLVP) was reported to have a strong correlation with Tau. Therefore, LV chamber stiffness (c-stiffness) may be assessed with the use of two LV diastolic pressure-volume coordinates: the mLVP and volume and the end-diastolic pressure (EDP) and volume. Purpose We sought to noninvasively assess LV stiffness using STE and validate the value by cardiac catheterization. Methods Echocardiography and catheterization were performed in 124 patients (age 72±8) (70 angina pectoris, 20 prior myocardial infarction, 19 hypertensive heart disease, 11 congestive heart failure and 4 paroxysmal atrial fibrillation). The ePCWP (mmHg) is noninvasively obtained as 10.8 − 12.4 × Log (left atrial active emptying function/minimum volume) and the eTau (ms) is obtained as isovolumic relaxation time/(ln 0.9 × systolic blood pressure − ln ePCWP) as previously reported. The mLVP (e-mLVP) was estimate using Tau. The estimated EDP (e-EDP) was calculated as 12.3 − 10.1 × Log (left atrial active emptying function / minimum volume). LV c-stiffness (mmHg/ml) was calculated as LV pressure change (from mLVP to EDP) obtained by catheterization divided by LV volume change during diastole which equals to stroke volume by echocardiography. Estimated c-stiffness (e-c-stiffness) was noninvasively obtained using e-mLVP and e-EDP. Furthermore, LV myocardial stiffness (m-stiffness) was calculated by LVED stress / LV longitudinal strain by STE, where LV stress (kdynes/cm2) was calculated as 0.334 × pressure × dimension / [thickness (1 + thickness/dimension)]. The estimated m-stiffness (e-m-stiffness) was calculated using e-EDP. Results The eTau and e-EDP estimated by STE had a good correlation with Tau and EDP invasively obtained by catheterization (r=0.75 and 0.63, respectively, both p<0.001). There was a good correlation between Tau and mLVP (Tau = 2.06 mLVP + 33.7, r=0.70). The estimated LVED stress had good correlation with ED stress obtained by catheterization (r=0.77, p<0.001). The e-c-stiffness and e-m-stiffness had a good correlation with those obtained by catheterization (e-c-stiffness; 0.116±0.07 and c-stiffness; 0.115±0.06, r=0.603, e-m-stiffness; 0.81±0.41 and m-stiffness; 0.85±0.45, r=0.89, respectively). Bland-Altman analysis revealed a good agreement between e-c-stiffness and c-stiffness, and between e-m-stiffness and m-stiffness without fixed and proportional bias. Conclusion This study demonstrated that LV stiffness may be noninvasively assessed by STE with reasonable accuracy and may have utility and value in the routine clinical practice for the diagnosis and treatment in patients with diastolic dysfunction.

Prognostic role of left ventricular diastolic function assessed by speckle tracking echocardiography in patients after surgical ventricular repair

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
O Nemchyna ◽  
N Solowjowa ◽  
M Dandel ◽  
Y Hrytsyna ◽  
J Stein ◽  
...  
Keyword(s):  
Diastolic Function ◽  
Speckle Tracking ◽  
Speckle Tracking Echocardiography ◽  
Left Ventricular ◽  
Prognostic Role ◽  
Significant Difference ◽  
All Cause Mortality ◽  
Lv Diastolic Function ◽  
Lv Aneurysm

Abstract Background Assessment of left ventricular (LV) diastolic function brings important prognostic information for patients with heart failure and could be evaluated by speckle tracking echocardiography (STE). Less known about its role in patients planned for surgical ventricular repair due to LV aneurysm. Purpose The aim of this study was to evaluate the prognostic role of STE parameters of LV diastolic function for prediction of all-cause mortality in patients after surgical ventricular repair. Methods We retrospectively evaluated data of 163 consecutive pts (mean age 62.3±11.5 years, 74.8% males) with anteroapical LV aneurysm who underwent surgical ventricular repair combined with coronary artery bypass surgery (71.8%) Prognostic role for prediction of all-cause mortality was assessed for various STE parameters, including left atrial strain (LAS) measured as peak reservoir strain and for the ratio of early to late global longitudinal strain rate (GLSRe/GLSRa). Results During a median follow-up of 4.7 years (IQR: 1.6–8.9 years) there were 65 deaths, 5 year survival rate was 73.8 (95% CI 67–79%). Baseline ejection fraction, end-diastolic and end-systolic volumes of LV did not differ between pts who died and survived at 5 year after the surgery, whereas LAS was significantly higher and GLSRe/GLSRa was significantly lower in survivors. Cox proportional hazard model adjusted to demographic and clinical variables demonstrated that LAS and GLSRe/GLSRa were independent predictors of all-cause death, with HR of 0.79 (95% CI 0.66–0.95, p=0.012) for each 5% increase of LAS and HR of 1.24 (95% CI 1.1–1.4, p=0.001) for each 0.5 increase of GLSRe/GLSRa. Moreover, GLSRe/GLSRa remained an independent predictor after additional adjustment for LV end-systolic volume, sphericity index and presence of mitral insufficiency of grade 2 and higher. A significant difference in median survival time was demonstrated according to the following cut-offs: LAS ≥16.7% (12.1 vs. 6.4 years, p=0.01), GLSRe/GLSRa ratio ≥2.3 (3.3 years vs. 10.2 years, p=0.0005) (Figure). The classification and regression tree analysis with the application of all two-dimensional, Doppler and various speckle-tracking echocardiographic parameters revealed that GLSRe/GLSRa and LAS were the most important echocardiographic variables for risk stratification for 5-year mortality. Conclusion This study demonstrates that STE parameters of LV diastolic function are important predictors of all-cause mortality after surgical ventricular repair due to anteroapical aneurysm of LV and could be used in the preoperative decision-making process. Funding Acknowledgement Type of funding source: None

scholarly journals Left Atrial Longitudinal Strain Evaluated by 2D Speckle Tracking Echocardiography Can Identify Patients with Heart Failure with Preserved Ejection Fraction

2019 ◽  
Vol 16 (1) ◽  
pp. 7-19
Author(s):  
Mihaela Bolog ◽  
Mihaela Dumitrescu ◽  
Mârzan Luminiţa ◽  
Florentina Romanoschi ◽  
Elena Păcuraru ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Diastolic Function ◽  
Left Atrial ◽  
Speckle Tracking ◽  
Longitudinal Strain ◽  
Signs And Symptoms ◽  
Left Ventricular Diastolic Function ◽  
Left Ventricular ◽  
Preserved Ejection Fraction

AbstractThe aim of the paper is to investigate the utility of left atrial longitudinal strain (LALS) in the diagnosis of heart failure with preserved ejection fraction (HFpEF) when left ventricular diastolic function is indeterminable and the assessment of natriuretic peptides is not routinely performed.Method. The study included 180 patients with signs and symptoms suggestive of non-acute heart failure, examined clinically and echocardiographically, both conventionally and via speckle tracking method.Results. 33 patients had a normal echocardiographic examination. Diastolic dysfunction (DD) was present in 116 patients of whom 32 patients had grade I, 66 patients grade II, 18 patients grade III DD. Diastolic function could not be determined in 31 patients. The mean value of LALS and NTproBNP in patients with normal echocardiography was significantly different from the group with DD for both variables (p<0.001). LALS was inversely correlated with the grade of DD (r=-0.83, p<0.001). The cut-off value of LALS for predicting DD was 25%. Applying this value in patients with indeterminate diastolic function we identified 21 patients with HFpEF (p<0.001).Conclusions. LALS can help in the diagnosis of HFpEF when other echocardiographic criteria are irrelevant and NTproBNP is not routinely performed. LALS was correlated with the presence and severity ofDDwith a cut-off value of 25%.

scholarly journals P1294Evaluation of right atrium mechanics and relation with loading conditions by speckle tracking echocardiographyP1295Late detection of left ventricular dysfunction using 2D and 3D speckle-tracking in patients with history of non-severe acute myocarditisP1296The impact of abnormal circadian BP profile on left atrial function by 2D speckle tracking echocardiography and its effect on functional capacity in hypertensive patientsP1297Right heart echocardiographic parameters alterations in asymptomatic breast cancer patients during chemotherapyP1299The Impact of myocardial deformation imaging for assessment of long-life prognosis in young patients with Kawasaki diseasesP1300Early detection of lv systolic dysfunction in asymptomatic patients with rheumatoid arthritis using global longitudinal strain assessmentP1301Cardiovascular risk assessment in haemodialysis patients with preserved left ventricular ejection fraction and left ventricular hypertrophyP1302Echocardiographic determinants of the functional capacity in systemic sclerosis: role of the right heartP1303 Speckle tracking echocardiography assessment of left atrial strain in hypertensive patientsP1304Comparison of global longitudinal strain in rheumatic mitral regurgitation and degenerative mitral regurgitation : does etiology affect?P1305Specific correlations between aortic stiffness and three-dimensional speckle-tracking echocardiography-derived segmental left ventricular strainsP1306Three-dimensional right ventricular strain analysis for the dependency of preload changes

2016 ◽  
Vol 17 (suppl 2) ◽  
pp. ii277-ii280
Author(s):  
S. Unlu ◽  
T. Caspar ◽  
T. Ahmed ◽  
M. Abdar Esfahani ◽  
R. Marinov ◽  
...  
Keyword(s):  
Mitral Regurgitation ◽  
Functional Capacity ◽  
Left Atrial ◽  
Speckle Tracking ◽  
Longitudinal Strain ◽  
Speckle Tracking Echocardiography ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction

P3548Noninvasive estimation of left ventricular diastolic function in patients with hypertension and normal ejection fraction using 3-dimensional speckle tracking echocardiography

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
S Minatoguchi ◽  
R Tanaka ◽  
T Yoshizane ◽  
T Deguchi ◽  
H Sato ◽  
...  
Keyword(s):  
Diastolic Function ◽  
Speckle Tracking ◽  
Speckle Tracking Echocardiography ◽  
Diastolic Pressure ◽  
Left Ventricular Diastolic Function ◽  
Left Ventricular ◽  
Peak Strain ◽  
Myocardial Stiffness ◽  
The Impact ◽  
Lv Diastolic Function

Abstract Background Left ventricular (LV) relaxation (eTau) and pulmonary capillary wedge pressure (ePCWP) were reported to be estimated by speckle tracking echocardiography (STE). LV camber stiffness (e-c stiffness) may be estimated with the use of 2 diastolic pressure-volume coordinates. The minimum diastolic pressure (mP) is reported to have a strong correlation with Tau. Purpose We sought to examine the impact of hypertension on LV diastolic function and LA properties and to elucidate the feature of hypertensive heart failure with preserved EF (HFpEF). Methods The e', E/e', Tau, PCWP, LVEDP, LV stiffness, LAV, LA emptying function (LAEF) and LA strain were examined in 53 controls (age 66±11), 136 hypertensive patients (HTN) with normal EF (69±11) and 39 HFpEF (77±14). ePCWP and estimated EDP (eEDP) was calculated as previously reported. Tau was calculated as isovolumic relaxation time/(ln 0.9 x systolic blood pressure − ln PCWP). Myocardial stiffness (e-m stiffness) was estimated as LVED stress/LV strain. LV c-stiffness was calculated as LV pressure change (from mP to EDP) obtained by catheterization divided by LV volume change. Estimated LV c-stiffness (e-c-stiffness) was noninvasively obtained using e-mP and e-EDP. The eTau, eEDP and e-mP by STE were validated by catheterization (n=126). Results The mP had a good correlation with Tau (r=0.70, p<0.01). The eTau, eEDP and e-mP by STE had a good correlation with those by catheterization (r=0.75, 0.63 and 0.70, p<0.01). Multivariate analysis revealed that ePCWP and LA strain were independent predictors of HFpEF. LV diastoric function Variables Control HTN HFpEF LVEF, % 68±6 68±8 63±9*+ LV longitudinal strain x (s–1) 19.1±3.0 16.8±4.3* 14.5±5.1*+ E/e' 9.2±2.6 11.6±4.5* 15.9±7.9*+ eTau, ms 35±12 48±17* 59±17*+ ePCWP, mmHg 7.3±2.7 8.3±4.3 15.0±4.4*+ eLVEDP, mmHg 9.4±2.2 10.4±3.5 15.9±3.7*+ LV e-myocardial stiffness, kdynes/cm 0.56±0.25 0.69±0.56 1.27±0.71*+ LV e-chamber stiffness, mmHg/ml 0.19±0.06 0.20±0.08 0.36±0.19*+ Maximum LAVI, ml/m2 42±15 50±21* 68±17*+ Total LAEF, % 55±7 51±11 36±12*+ LA peak strain 41±15 40±17 19±8*+ *p<0.05 vs Control, +p<0.05 vs HTN. Conclusion We demonstrated that LV diastolic function in HTN may be accurately and noninvasively evaluated by STE.

scholarly journals Direct comparison of multilayer left ventricular global longitudinal strain using CMR feature tracking and speckle tracking echocardiography

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Saikrishna Ananthapadmanabhan ◽  
Giau Vo ◽  
Tuan Nguyen ◽  
Hany Dimitri ◽  
James Otton
Keyword(s):  
Feature Tracking ◽  
Speckle Tracking ◽  
Longitudinal Strain ◽  
Speckle Tracking Echocardiography ◽  
Imaging Modality ◽  
Global Longitudinal Strain ◽  
Intraclass Correlation ◽  
Strain Analysis ◽  
Left Ventricular ◽  
Multilayer Strain

Abstract Background Cardiac magnetic resonance feature tracking (CMR-FT) and speckle tracking echocardiography (STE) are well-established strain imaging modalities. Multilayer strain measurement permits independent assessment of endocardial and epicardial strain. This novel and layer specific approach to evaluating myocardial deformation parameters may provide greater insight into cardiac contractility when compared to whole-layer strain analysis. The aim of this study is to validate CMR-FT as a tool for multilayer strain analysis by providing a direct comparison between multilayer global longitudinal strain (GLS) values between CMR-FT and STE. Methods We studied 100 patients who had an acute myocardial infarction (AMI), who underwent CMR imaging and echocardiogram at baseline and follow-up (48 ± 13 days). Dedicated tissue tracking software was used to analyse single- and multi-layer GLS values for CMR-FT and STE. Results Correlation coefficients for CMR-FT and STE were 0.685, 0.687, and 0.660 for endocardial, epicardial, and whole-layer GLS respectively (all p < 0.001). Bland Altman analysis showed good inter-modality agreement with minimal bias. The absolute limits of agreement in our study were 6.4, 5.9, and 5.5 for endocardial, whole-layer, and epicardial GLS respectively. Absolute biases were 1.79, 0.80, and 0.98 respectively. Intraclass correlation coefficient (ICC) values showed moderate agreement with values of 0.626, 0.632, and 0.671 respectively (all p < 0.001). Conclusion There is good inter-modality agreement between CMR-FT and STE for whole-layer, endocardial, and epicardial GLS, and although values should not be used interchangeably our study demonstrates that CMR-FT is a viable imaging modality for multilayer strain

Early change in left atrial and left ventricular strain predicts sinus rhythm maintenance after cardioversion

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
K Kupczynska ◽  
D Miskowiec ◽  
B Michalski ◽  
L Szyda ◽  
K Wierzbowska-Drabik ◽  
...  
Keyword(s):  
Sinus Rhythm ◽  
Left Atrial ◽  
Speckle Tracking ◽  
Longitudinal Strain ◽  
Global Longitudinal Strain ◽  
Recurrence Risk ◽  
Left Ventricular ◽  
Mechanical Function ◽  
Af Recurrence

Abstract Background Atrial fibrillation (AF) impairs mechanical function of the heart, especially atria and restoration of sinus rhythm (SR) leads to improvement of mechanics. The predicting role of changes in strain parameters for AF recurrence is not established yet. Purpose To analyse changes in left atrial (LA) and left ventricular (LV) mechanical function after conversion to SR and their prognostic values for AF recurrence during 24 months follow-up. Methods Prospective study involved 59 patients after successful electrical cardioversion (EC) because of nonvalvular AF (mean age 65±4 years, 47% female). Speckle tracking analysis (STE) was applied to calculate longitudinal strain of LV and LA before EC and within 24 hours after restoration of SR and additionally total left heart strain (TS) defined as a sum of absolute peak LV and LA strain. We calculated change in strain between AF and SR analyses expressed as delta (Δ). During follow-up we noticed AF recurrence in 42 (71%) patients, most of them (93%) during 1st year after EC. Median time of AF recurrence was 3 months. Results We noticed significant immediate post-EC improvement in peak LA longitudinal strain (PALS) and LV global longitudinal strain (LVGLS) (table). Unlike CHA2DS2-VASc score, strain parameters were predictors of AF recurrence. Every 1% increment in ΔLVGLS was related with 13% increase in AF recurrence risk (p=0.02) and every 1% increment in ΔPALS and ΔTS were related with 9% decrease in AF recurrence risk (p=0.007 and p=0.0014, respectively). Multivariate analysis revealed ΔTS as a strongest predictor with 9% decrease in AF risk per every 1% increment. The criterion of ΔTS ≤7.5% allows to predict AF recurrence with 81% sensitivity and 63% specificity. Conclusions Speckle tracking measurements are able to detect early mechanical changes in LA even within 24 hours of SR and these absolute changes in LVGLS as well as PALS can predict AF recurrence, with optimal stratification by novel parameter - TS. Funding Acknowledgement Type of funding source: None

scholarly journals Atrial and Ventricular Structural and Functional Alterations in Obese Children

Medicina ◽  
2021 ◽  
Vol 57 (6) ◽  
pp. 562
Author(s):  
Rima Šileikienė ◽  
Karolina Adamonytė ◽  
Aristida Ziutelienė ◽  
Eglė Ramanauskienė ◽  
Jolanta Justina Vaškelytė
Keyword(s):  
Speckle Tracking ◽  
Longitudinal Strain ◽  
Speckle Tracking Echocardiography ◽  
Myocardial Dysfunction ◽  
Global Longitudinal Strain ◽  
Radial Strain ◽  
Left Ventricular ◽  
Z Score ◽  
Obese Children ◽  
2D Speckle Tracking

Background and objectives: Childhood obesity has reached epidemic levels in the world. Obesity in children is defined as a body mass index (BMI) equal to or above the 95th percentile for age and sex. The aim of this study was to determine early changes in cardiac structure and function in obese children by comparing them with their nonobese peers, using echocardiography methods. Materials and methods: The study enrolled 35 obese and 37 age-matched nonobese children. Standardized 2-dimensional (2D), pulsed wave tissue Doppler, and 2D speckle tracking echocardiography were performed. The z-score BMI and lipid metabolism were assessed in all children. Results: Obese children (aged 13.51 ± 2.15 years; 20 boys; BMI z-score of 0.88 ± 0.63) were characterized by enlarged ventricular and atrial volumes, a thicker left ventricular posterior wall, and increased left ventricular mass. Decreased LV and RV systolic and diastolic function was found in obese children. Atrial peak negative (contraction) strain (−2.05% ± 2.17% vs. −4.87% ± 2.97%, p < 0.001), LV and RV global longitudinal strain (−13.3% ± 2.88% vs. −16.87% ± 3.39%; −12.51% ± 10.09% vs. −21.51% ± 7.42%, p < 0.001), and LV global circumferential strain (−17.0 ± 2.7% vs. −19.5 ± 2.9%, p < 0.001) were reduced in obese children. LV torsion (17.94° ± 2.07° vs. 12.45° ± 3.94°, p < 0.001) and normalized torsion (2.49 ± 0.4°/cm vs. 1.86 ± 0.61°/cm, p = 0.001) were greater in obese than nonobese children. A significant inverse correlation was found between LV and RV global longitudinal strain and BMI (r = −0.526, p < 0.01; r = −0.434, p < 0.01) and total cholesterol (r = −0.417, p < 0.01). Multivariate analysis revealed that the BMI z-score was independently related to LV and RV global longitudinal strain as well as LV circumferential and radial strain. Conclusion: 2D speckle tracking echocardiography is beneficial in the early detection of regional LV systolic and diastolic dysfunctions, with preserved ejection fraction as well as additional RV and atrial involvement, in obese children. Obesity may negatively influence atrial and ventricular function, as measured by 2D speckle tracking echocardiography. Obese children, though they are apparently healthy, may have subclinical myocardial dysfunction.

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