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September 10, 2026Cardiology in the Young

Left ventricular rotational mechanics in children with dilated cardiomyopathy: reverse apical rotation indicates a poor prognosis

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Why the study?

Does reverse apical rotation assessed by 2D-speckle tracking indicate a poor prognosis in children with dilated cardiomyopathy?

Comparison

Patients with dilated cardiomyopathy vs age- and sex-matched controls

Follow-up

6 years

Key result

Reverse apical rotation in children with dilated cardiomyopathy was associated with poorer outcomes over a 6-year follow-up period.

Authors

AMAndrea E. MonteroDSDhiran SivasubramanianMOMatthew O'Connor

Discussion

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Overview

May support risk stratification in pediatric DCM; leaves open incremental prognostic value beyond standard measures.

Key Points

  • To evaluate left ventricular rotational mechanics and their association with clinical prognosis in pediatric dilated cardiomyopathy.
  • Recruited 23 children with dilated cardiomyopathy and 10 age- and sex-matched controls.
  • Evaluated left ventricular apical and basal rotational mechanics using 2D-speckle tracking imaging.
  • Conducted clinical follow-up over a period of 6 years.
  • Among the 23 patients with dilated cardiomyopathy, 10 demonstrated diminished rotation and 13 exhibited reverse apical rotation.
  • Patients with reverse apical rotation experienced significantly poorer clinical outcomes compared to those with diminished rotation during the 6-year follow-up.

Study Design

Type

Observational (n=33)

Structured PICO

Does reverse apical rotation assessed by 2D-speckle tracking indicate a poor prognosis in children with dilated cardiomyopathy?

P
Population
33 children (23 with dilated cardiomyopathy and 10 age- and sex-matched controls) evaluated using 2D-speckle tracking and followed for 6 years.
E
Exposure
Assessment of left ventricular rotational mechanics (apical and basal rotation) using 2D-speckle tracking echocardiography
C
Comparator
Age- and sex-matched healthy controls
O
Outcome
Clinical outcomes/prognosis at 6 years follow-up

Reverse apical rotation identified via 2D-speckle tracking echocardiography may serve as a marker for poor prognosis in children with dilated cardiomyopathy.

Cite This Study

Montero et al. (2026) conducted an observational in Dilated cardiomyopathy (n=33). Reverse apical rotation vs. Diminished rotation or normal rotation was evaluated on Poorer outcomes. Reverse apical rotation in children with dilated cardiomyopathy was associated with poorer outcomes over a 6-year follow-up period.

synapsesocial.com/papers/6aa27ad858559d80afc73a7ahttps://doi.org/10.1017/s1047951126123920
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