Advanced Echocardiographic Characterization of Neonatal Ebstein’s Anomaly Using Myocardial Deformation Imaging: A Single-Center Study

Figures

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  Figure 1. Representative conventional two-dimensional echocardiographic assessment in a neonate with Ebstein’s anomaly. Legend: (A) Apical four-chamber view illustrating the calculation of the Great Ormond Street Echocardiographic (GOSE) score, defined as the ratio of the combined area of the right atrium and atrialized right ventricle to the area of the functional right ventricle, left ventricle, and left atrium; (B) Left ventricular ejection fraction (LV_EF) measurement using Simpson’s biplane method.

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  Figure 2. Representative speckle-tracking echocardiography (STE) analysis in a neonate with Ebstein’s anomaly. Legend: (A) Right ventricular longitudinal strain analysis from the apical four-chamber view, including free-wall and four-chamber strain curves; (B) Left ventricular global longitudinal strain (LV_GLS) derived from apical four-, two-, and three-chamber views, with corresponding bull’s-eye plot; (C) Left atrial strain analysis demonstrating reservoir, conduit, and contractile phases; (D) Right atrial strain analysis demonstrating impaired atrial deformation.

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  Figure 3. Comparison of structural and functional echocardiographic parameters between control neonates and those with Ebstein’s anomaly. Legend: (A) Structural remodeling (right atrial and left ventricular areas); (B) Right ventricular systolic function (TAPSE, RV_FAC, tricuspid S); (C) Left ventricular systolic function (LV_EF, MAPSE); (D) Diastolic function (tricuspid and mitral IVRT). Data are presented as mean ± SD. Asterisks indicate levels of statistical significance between groups (* p < 0.05, ** p < 0.01, *** p < 0.001).

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  Figure 4. Comparison of echocardiographic functional parameters across Carpentier subtypes (A, B, C) in neonates with Ebstein’s anomaly. Bar graphs illustrate progressive deterioration in right ventricular systolic and diastolic function with increasing anatomical severity. * Data are presented as mean ± SD; error bars represent standard deviation. p < 0.05.

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  Figure 5. (A) Receiver operating characteristic (ROC) curve analysis of myocardial deformation parameters in neonates with Ebstein’s anomaly. ROC curves illustrating the diagnostic performance of speckle-tracking echocardiography–derived strain parameters in differentiating neonates with Ebstein’s anomaly from healthy controls. Right ventricular (RV) strain parameters, including RV_BRV_B: basal right ventricle segment longitudinal strain; RV_MRV_B: mid right ventricle segment longitudinal strain; RV_ARV_B: apical right ventricle segment longitudinal strain; RV free-wall longitudinal strain (RV_FWSL_B) and RV four-chamber longitudinal strain (RV_4CSL_B). The diagonal reference line represents the line of no discrimination (area under the curve = 0.5). Higher curves indicate better diagnostic performance of the corresponding parameter. (B) Receiver operating characteristic (ROC) curve analysis of myocardial deformation parameters in neonates with Ebstein’s anomaly. ROC curves illustrating the diagnostic performance of speckle-tracking echocardiography–derived strain parameters in differentiating neonates with Ebstein’s anomaly from healthy controls. Left ventricular (LV) strain parameters,…