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Tissue Doppler, strain, and strain rate measurements assessed by two-dimensional speckle-tracking echocardiography in healthy newborns and infants

Published online by Cambridge University Press:  07 February 2013

Ozlem Elkiran ,
Cemsit Karakurt ,
Gulendam Kocak  and
Ahmet Karadag
Ozlem Elkiran*
Affiliation:
Department of Pediatric Cardiology, Faculty of Medicine, Inonu University, Malatya, Turkey
Cemsit Karakurt
Affiliation:
Department of Pediatric Cardiology, Faculty of Medicine, Inonu University, Malatya, Turkey
Gulendam Kocak
Affiliation:
Department of Pediatric Cardiology, Faculty of Medicine, Maltepe University, İstanbul, Turkey
Ahmet Karadag
Affiliation:
Department of Neonatology, Faculty of Medicine, Inonu University, Malatya, Turkey
*
Correspondence to: Dr O. Elkiran MD, Department of Pediatric Cardiology, Faculty of Medicine, Inonu University, Malatya 42200, Turkey. Tel: +90-422-3410660-5309; Fax: +90-422-3410728; E-mail: [email protected]
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Abstract

Objectives

To evaluate cardiac maturational and haemodynamic alteration in healthy newborns and infants and determine reference values in this period using tissue Doppler, strain, and strain rate echocardiography.

Material and Methods

The study included 149 healthy subjects. Babies from 1 day to 3 months were selected from the well-baby nursery department, and infants were selected from paediatric clinics during routine visits for health maintenance. Subjects were allocated to four groups: preterm (36–37 weeks, n = 32), term (≥38 weeks, n = 32), 1 month of age (n = 47), and 3 months of age (n = 38). Standard echocardiographic evaluations, pulsed wave Doppler, tissue Doppler echocardiography, strain, and strain rate studies were applied by the same person using a MyLab50 echo machine. Longitudinal and circumferential systolic strain and strain rate measurements were assessed by two-dimensional speckle-tracking echocardiography in all subjects.

Results

The longitudinal systolic velocity, strain, and strain rate values derived from left ventricle apical four-, three-, and two-chamber images, and circumferential systolic velocity, strain, and strain rate values derived from left ventricle short-axis images decreased from the base to the apex in all subjects (p < 0.001).

Conclusion

Significant cardiac haemodynamic alterations occurred during the newborn and early infancy periods and were detected by tissue Doppler, strain, and strain rate echocardiography. Although two-dimensional speckle-tracking echocardiography is useful and can produce improved, reliable results in clinical practice, it has some limitations. Therefore, more studies on this issue are required.

Keywords

Newborninfanttissue Dopplerstrainstrain rate
Type
Original Articles
Information
Cardiology in the Young , Volume 24 , Issue 2 , April 2014 , pp. 201 - 211
Copyright
Copyright © Cambridge University Press 2013 

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References

1. Anderson, PAW. Myocardium and development. In: Anderson RH, Baker EJ, Penny DJ, Redington AN, Rigby ML, Wernosky G (eds.). Paediatric Cardiology, 3rd edn. Churchill Livingstone, Philadelphia, 2010: 57–72.CrossRefGoogle Scholar
2. Anversa, P, Olivetti, G, Loud, AV. Morphometric study of early postnatal development in the left and right ventricular myocardium of the rat. I. Hypertrophy, hyperplasia, and binucleation of myocytes. Circ Res 1980; 46: 495–502.CrossRefGoogle ScholarPubMed
3. Stopfkuchen, H. Changes of the cardiovascular system during the perinatal period. Eur J Pediatr 1987; 146: 545–549.CrossRefGoogle ScholarPubMed
4. Ichihashi, K, Ewert, P, Welmitz, G, Lange, P. Changes in ventricular and muscle volumes of neonates. Pediatr Int 1999; 41: 8–12.CrossRefGoogle ScholarPubMed
5. Blackburn, S. Placental, fetal, and transitional circulation revisited. J Perinat Neonatal Nurs 2006; 20: 290–294.Google Scholar
6. Roberson, DA, Cui, W, Chen, Z, Madronero, LF, Cuneo, BF. Annular and septal Doppler tissue imaging in children: normal z-score tables and effects of age, heart rate, and body surface area. J Am Soc Echocardiogr 2007; 20: 1276–1284.CrossRefGoogle ScholarPubMed
7. Eidem, BW, McMahon, CJ, Cohen, RR, et al. Impact of cardiac growth on Doppler tissue imaging velocities: a study in healthy children. J Am Soc Echocardiogr 2004; 17: 212–221.Google Scholar
8. Dragulescu, A, Mertens, LL. Developments in echocardiographic techniques for the evaluation of ventricular function in children. Arch Cardiovasc Dis 2010; 103: 603–614.Google Scholar
9. Sutherland, GR, Di Salvo, G, Claus, P, D'Hooge, J, Bijnens, B. Strain and strain rate imaging: a new clinical approach to quantifying regional myocardial function. J Am Soc Echocardiogr 2004; 17: 788–802.Google Scholar
10. Bussadori, C, Moreo, A, Di Donato, M, et al. A new 2D-based method for myocardial velocity strain and strain rate quantification in a normal adult and paediatric population: assessment of reference values. Cardiovasc Ultrasound 2009; 7: 8.CrossRefGoogle Scholar
11. Sahn, DJ, DeMaria, A, Kisslo, J, Weyman, A. Recommendations regarding quantitation in M-mode echocardiography: results of a survey of echocardiographic measurements. Circulation 1978; 58: 1072–1083.CrossRefGoogle ScholarPubMed
12. Rychik, J, Tian, ZY. Quantitative assessment of myocardial tissue velocities in normal children with Doppler tissue imaging. Am J Cardiol 1996; 77: 1254–1257.Google Scholar
13. Leitman, M, Lysyansky, P, Sidenko, S, et al. Two-dimensional strain: a novel software for real-time quantitative echocardiographic assessment of myocardial function. J Am Soc Echocardiogr 2004; 17: 1021–1029.Google Scholar
14. Mori, K, Nakagawa, R, Nii, M, et al. Pulsed wave Doppler tissue echocardiography assessment of the long axis function of the right and left ventricles during the early neonatal period. Heart 2004; 90: 175–180.CrossRefGoogle Scholar
15. Ekici, F, Atalay, S, Ozcelik, N, et al. Myocardial tissue velocities in neonates. Echocardiography 2007; 24: 61–67.CrossRefGoogle ScholarPubMed
16. Negrine, RJ, Chikermane, A, Wright, JG, Ewer, AK. Assessment of myocardial function in neonates using tissue Doppler imaging. Arch Dis Child Fetal Neonatal Ed 2012; 97: F304–F306.Google Scholar
17. Toyoda, T, Baba, H, Akasaka, T, et al. Assessment of regional myocardial strain by a novel automated tracking system from digital image files. J Am Soc Echocardiogr 2004; 17: 1234–1238.Google Scholar
18. Storaa, C, Aberg, P, Lind, B, Brodin, LA. Effect of angular error on tissue Doppler velocities and strain. Echocardiography 2003; 20: 581–587.Google Scholar
19. Ingul, CB, Torp, H, Aase, SA, et al. Automated analysis of strain rate and strain: feasibility and clinical implications. J Am Soc Echocardiogr 2005; 18: 411–418.CrossRefGoogle ScholarPubMed
20. Di Salvo, G, Russo, MG, Paladini, D, et al. Quantification of regional left and right ventricular longitudinal function in 75 normal fetuses using ultrasound-based strain rate and strain imaging. Ultrasound Med biol 2005; 31: 1159–1162.Google Scholar
21. Di Salvo, G, Russo, MG, Paladini, D, et al. Two-dimensional strain to assess regional left and right ventricular longitudinal function in 100 normal foetuses. Eur J Echocardiogr 2008; 9: 754–756.Google Scholar
22. Nestaas, E, Stoylen, A, Brunvand, L, Fugelseth, D. Tissue Doppler derived longitudinal strain and strain rate during the first 3 days of life in healthy term neonates. Pediatr Res 2009; 65: 357–362.Google Scholar
23. Kowalski, M, Kukulski, T, Jamal, F, et al. Can natural strain and strain rate quantify regional myocardial deformation? A study in healthy subjects. Ultrasound Med Biol 2001; 27: 1087–1097.Google Scholar
24. Andersen, NH, Poulsen, SH. Evaluation of the longitudinal contraction of the left ventricle in normal subjects by Doppler tissue tracking and strain rate. J Am Soc Echocardiogr 2003; 16: 716–723.Google Scholar
25. Sun, JP, Popovic, ZB, Greenberg, NL, et al. Noninvasive quantification of regional myocardial function using Doppler-derived velocity, displacement, strain rate, and strain in healthy volunteers: effects of aging. J Am Soc Echocardiogr 2004; 17: 132–138.CrossRefGoogle ScholarPubMed
26. Lorch, SM, Ludomirsky, A, Singh, GK. Maturational and growth-related changes in left ventricular longitudinal strain and strain rate measured by two-dimensional speckle tracking echocardiography in healthy pediatric population. J Am Soc Echocardiogr 2008; 21: 1207–1215.Google Scholar
27. Pena, JL, da Silva, MG, Faria, SC, et al. Quantification of regional left and right ventricular deformation indices in healthy neonates by using strain rate and strain imaging. J Am Soc Echocardiogr 2009; 22: 369–375.Google Scholar
28. Marijianowski, MM, van der Loos, CM, Mohrschladt, MF, Becker, AE. The neonatal heart has a relatively high content of total collagen and type I collagen, a condition that may explain the less compliant state. J Am Coll Cardiol 1994; 23: 1204–1208.Google Scholar
29. Pena, JL, da Silva, MG, Alves, JM Jr, et al. Sequential changes of longitudinal and radial myocardial deformation indices in the healthy neonate heart. J Am Soc Echocardiogr 2010; 23: 294–300.CrossRefGoogle ScholarPubMed
30. Boettler, P, Hartmann, M, Watzl, K, et al. Heart rate effects on strain and strain rate in healthy children. J Am Soc Echocardiogr 2005; 18: 1121–1130.Google Scholar