Echocardiographic assessment of left ventricular dyssynchrony in Egyptian children with congestive heart failure due to dilated cardiomyopathy

OBJECTIVE: To evaluate the presence of cardiac dyssynchrony in Egyptian children with congestive heart failure due to dilated cardiomyopathy. MATERIALS AND METHODS: A total of 30 children with congestive cardiac failure due to dilated cardiomyopathy and 30 healthy age-matched controls were examined with conventional echocardiography, tissue Doppler, and speckle tracking imaging. RESULTS: Conventional Doppler echocardiography demonstrated significant left ventricular systolic and diastolic dysfunction in the patient group. Tissue Doppler showed significant decrease in S-wave velocity and E'/A' ratio, and prolonged isovolumic contraction and relaxation times of mitral annulus as well as significant prolongation in mean difference between time-to-peak systolic strain of the basal septal and basal lateral segments in the patient group compared with the control group (p<0.005). Speckle tracking imaging demonstrated significant prolongation in mean difference between time-to-peak systolic strain of anteroseptal and posterior segments in both circumferential and radial strain analysis in the patient group than in the control group (p<0.005). It also demonstrated significant prolongation in the mean difference between time-to-peak systolic strain of the basal septal and basal lateral segments in longitudinal strain analysis in the patient group than in the control group (p<0.005). A significant increase in the standard deviation of time-to-peak strain, as a marker of increased intra-ventricular dyssynchrony, was present in the patient group compared with the control group (p=0.008). CONCLUSION: Children with congestive heart failure due to dilated cardiomyopathy usually suffer from significant intra-ventricular dyssynchrony. Tissue Doppler imaging and speckle tracking imaging strain analysis are helpful tools to detect the presence of cardiac dyssynchrony.