Right ventricular strain in children with dilated cardiomyopathy was significantly lower compared to controls, indicating a basal-predominant deformation pattern.
Does biventricular strain assessment using 2D-STE improve the identification of advanced functional limitation in children with dilated cardiomyopathy?
Biventricular strain assessment using 2D-STE identifies a basal-predominant right-ventricular dysfunction pattern in pediatric DCM and accurately discriminates advanced functional limitation.
Absolute Event Rate: 0% vs 0%
Background: Right-ventricular (RV) involvement is starting to gain recognition in pediatric dilated cardiomyopathy (DCM), but its deformation characteristics and its relationship to functional status remain insufficiently defined. Methods: Twenty-nine children with primary DCM were compared with age- and sex-matched healthy controls. Conventional echocardiography and two-dimensional speckle-tracking echocardiography (2D-STE) were performed. Segmental deformation (basal, mid-ventricular and apical levels) was analyzed using a linear mixed-effects model. Associations between strain indices and advanced functional limitation (NYHA/Ross Class III-IV) were evaluated using exploratory logistic regression and ROC analysis. Results: Children with DCM showed significant impairment in both ventricles. Conventional parameters (TAPSE, tricuspid E/A ratio, RV E′ velocity, and LV ejection fraction) were reduced. Right ventricular strain was significantly lower in DCM compared with controls (p < 0.05). Segmental analysis demonstrated a basal-predominant reduction in RV strain. Right-ventricular free-wall longitudinal strain correlated with RV S′ (r = −0.49), RV E′ (r = −0.46), LVGLS (r = 0.79) and LV ejection fraction (r = −0.63, all p < 0.05). In univariable analysis, RVFWSL predicted advanced functional class (OR 1.13 per 1% decrease, p = 0.026), while LVGLS remained the independent predictor in the multivariable model. A combined model incorporating RVFWSL and LVGLS demonstrated excellent discriminative accuracy (AUC 0.95). Conclusions: Pediatric DCM is characterized by RV involvement with a distinct basal-dominant deformation pattern. Biventricular strain assessment improves the identification of children with advanced functional class and may enhance functional stratification beyond conventional indices.
Muntean et al. (Tue,) reported a other. Right ventricular strain in children with dilated cardiomyopathy was significantly lower compared to controls, indicating a basal-predominant deformation pattern.