Abstract 10777: Three-Dimensional Global Longitudinal Strain Analysis of Left Ventricle by Real-time 3-D Speckle Tracking Imaging in Pediatric Population: Feasibility, Reproducibility, Maturational Changes, and Normal Ranges
Background: Doppler and 2-D strain provide less load-dependent and sensitive measures of global and regional left ventricular (LV) function; but these measures are highly dependent on the sampling sites and planes with limited robustness and reproducibility. A 3-D strain analysis methodology may improve these limitations and potentially become the “Holy Grail” of left ventricle functional assessment.
Objectives: We sought: 1) to evaluate feasibility and reproducibility of LV global longitudinal strain (GLS) by real-time 3D speckle tracking imaging (RT 3D-STI); and 2) to establish the maturational growth pattern and normal values of GLS in a pediatric cohort.
Methods: A prospective study was conducted in 252 consecutive healthy subjects (131 male/121 female, mean age 6.23 ± 4.5 years, and range from birth to 18 years) using RT 3-D echocardiography (3DE)(IE33, Philips Medical Systems, Bothell, WA). The GLS measurements were made off-line using new TomTec software (4D LV-Analysis 3.0, TomTec Imaging Systems, Munich, Germany). Manual landmark selection and endocardial border editing were performed in 3 planes (apical 2-, 4-, and “3-“ chamber views) and semi-automated border identification and tracking yielded LV 3-D GLS and regional strains.
Results: GLS analysis by RT 3D-STI was feasible in 224 of 252 subjects (88.9%); data analysis was not possible in 28 subjects secondary to low frame rates or incomplete 3-D images. There is no correlation between GLS and age, height, weight, BSA and HR, respectively using canonical correlation analysis. Therefore, the mean GLS was -18.62% ± 2.70%; and 95% confidence interval -13.31 to -23.93 % in this entire cohort. The intra-observer and inter-observer variabilities were 1.4 ± 6.6%, and 1.6 ± 6.9%, respectively.
Conclusions: Our study demonstrated that GLS by this new 3-D strain analysis methodology using RT3D STI is feasible and reproducible in pediatric population. There is no maturational change in GLS in this cohort and the normal range is defined. Further investigation is warranted to validate the utility of this new methodology in congenital and acquired heart diseases.
- © 2011 by American Heart Association, Inc.