Relation of Longitudinal Strain to Conventional ECHO in Evaluation of Pediatric Dilated Cardiomyopathy in Children Heart Hospital/ Sulaymaniyah City

Background and objectives: While many dilated cardiomyopathy fatalities occur within the first year, patients are often diagnosed at advanced stages. This study evaluates the efficacy of longitudinal strain versus conventional 2D echocardiography for improving early detection and management in pediatric dilated cardiomyopathy. Methods: This prospective cross-sectional study was conducted from October to September 2024, at the Children Heart Hospital and Jamal Ahmad Rashid Pediatric Hospital ICU in Sulaimani, involving children aged 1 month to 15 years with dilated cardiomyopathy. Echocardiograms were performed using a GE Vivid E9 system by a pediatric cardiologist, assessing left ventricular function through 2D echocardiography, and longitudinal strain. Key parameters included left ventricular volumes, ejection fraction (Simpson's method), mitral valve excursion, and diastolic function (E/A ratio), in line with American Society of Echocardiography guidelines. Data were analyzed using SPSS version 27.0. Descriptive statistics summarized demographic and clinical variables, while t-tests and chi-square tests compared longitudinal strain with conventional 2D echocardiography in assessing pediatric dilated cardiomyopathy. Statistical significance was set at p<0.05. Results: The study involved 17 children (mean age: 7.06±3.11 years; 47.06% male, 52.94% female). Echocardiographic assessments indicated an average Simpson ejection fraction of 38.88% (range: 21.0-58.0), with 29.4% having an ejection fraction <35%, 52.9% between 35-49%, and 17.7% >50%. Simpson ejection fraction, M-mode ejection fraction, and Mitral Annular Plane Systolic Excursion significantly (p-value<0.05) decreased with age. Conclusion: Our study underscores the utility of longitudinal strain in enhancing the diagnostic accuracy of pediatric dilated cardiomyopathy when used alongside conventional echocardiography.