Speckle tracking-based fetal myocardial performance analysis

ABSTRACT Introduction Incidence of right ventricular (RV) dysfunction in early postoperative period after Tetralogy of Fallot (TOF) repair ranges from 28 to 63%. Echocardiography is the first-line tool for the assessment of RV function in early postoperative period. As speckle tracking echocardiography (STE) has emerged as a new promising tool for assessing myocardial performance and is independent of geometric assumptions and angle dependence, it is more sensitive for detecting changes in myocardial performance than conventional echocardiographic parameters of RV function. The current study demonstrates echocardiographic parameters assessed by conventional two-dimensional (2D) echocardiography and STE in patients before and after TOF repair. Materials and methods Fifty-nine consecutive patients planned for complete intracardiac repair for TOF were enrolled in this prospective cohort study. The 2D echocardiography and STE were performed a day prior to TOF repair, in the early postoperative period between days 3 and 7 and after discharge at 3 months. Results The median age of patients was 6 years, with 57.6% males (34/59). Baseline hemoglobin and room air oxygen saturation were 17.7 ± 3.7 gm% and 79.4% ± 8% respectively. Two patients did not survive the procedure (3.4%). Right ventricular longitudinal peak systolic strain (RV LPSS) in early postoperative period was significantly decreased in all segments of both septal and lateral wall. However, RV LPSS assessed at midterm follow-up at 3 months postoperatively significantly improved in all segments of RV compared with assessment done in the early postoperative period, and was significantly better than preoperative values in all three segments of the septal wall. Conclusion Our study shows that the use of 2D strain or speckle tracking is a feasible and easy-to-implement technique for the evaluation of RV function after TOF repair. How to cite this article Negi SL, Puri K, Mandal B, Rana SS, Barwad P. Right Ventricle Segmental Strain Trends in Patients undergoing Tetralogy of Fallot Repair: An Observational Study. J Perioper Echocardiogr 2016;4(2):45-50.

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Left ventricular myocardial performance in patients with dengue hemorrhagic fever and thrombocytopenia as assessed by two-dimensional speckle tracking echocardiography

Indian Heart Journal ◽

10.1016/j.ihj.2013.04.017 ◽

2013 ◽

Vol 65 (3) ◽

pp. 276-282 ◽

Cited By ~ 4

Author(s):

Shantanu P. Sengupta ◽

Abhijeet Nugurwar ◽

Rahul Jaju ◽

Bijoy K. Khandheria

Keyword(s):

Dengue Hemorrhagic Fever ◽

Speckle Tracking ◽

Speckle Tracking Echocardiography ◽

Hemorrhagic Fever ◽

Left Ventricular ◽

Two Dimensional ◽

Myocardial Performance

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Abstract 10876: Speckle-tracking vs. Pressure-Volume Loop Measures of Left Ventricular Systolic Function in Children: An Inter-vendor Comparison

Circulation ◽

10.1161/circ.132.suppl_3.10876 ◽

2015 ◽

Vol 132 (suppl_3) ◽

Author(s):

Shahryar M Chowdhury ◽

Ryan J Butts ◽

Carolyn L Taylor ◽

Karen S Chessa ◽

Anthony M Hlavacek ◽

...

Keyword(s):

Performance Analysis ◽

Gold Standard ◽

Speckle Tracking ◽

Systolic Function ◽

Ductus Arteriosus ◽

Left Ventricular ◽

Cardiac Performance ◽

Heart Catheterization ◽

Arterial Elastance ◽

Normal Loading

Introduction: The variability in speckle-tracking echocardiography (STE) algorithms between vendors is well recognized. While some are attempting to standardize algorithms across vendors, it is currently unknown which algorithm best compares to gold-standard measures of systolic function. The objective of this study was to compare STE measures of deformation from two vendors vs. gold-standard measures of LV contractility and global ventricular efficiency in children. Methods: Children with normal loading conditions undergoing routine left heart catheterization were prospectively enrolled. Pressure-volume loops were obtained via conductance catheterization. The gold-standard measure of contractility, end-systolic elastance (Ees), was obtained via balloon occlusion of the vena cavae. Ventriculo-arterial coupling was assessed using the arterial elastance to Ees ratio (Ea/ Ees). STE was performed immediately after PVL analysis under the same anesthetic conditions. Offline STE analysis was perfomed using both QLAB v9.0 (Phillips, Andover, MA) and Cardiac Performance Analysis v3.0 (Tomtec, Hamden, CT) by a single blinded observer. The relationships between PVL and STE measures of systolic function were determined using Spearman’s correlation. Results: Of 24 patients, 18 patients were s/p heart transplant, 6 patients had a small patent ductus arteriosus or small coronary fistula. Mean age was 9.1 ± 5.6 years. The average invasive Ees was 3.04 ± 1.65 mmHg/mL. The average Ea/Ees was 0.88 ± 0.35. Correlations between invasive Ees and Ea/Ees to STE measures of deformation are reported in the Table. Conclusion: STE measures of GLS and GLSR derived from Cardiac Performance Analysis have better correlation with gold-standard measures of cardiac performance when compared to QLAB. GCS derived from both vendors has no correlation to invasive measures. Attempts to standardize STE algorithms should take these results into consideration.

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