The clinical value of echocardiography in exploring cardiac structure and function in depressive disorder

OBJECTIVE: Depression is a common mental illness worldwide and has a bidirectional relationship with cardiovascular disease. However, research on the link between adolescent depression and cardiac structure/function remains limited and partly controversial. This study aims to investigate whether depression and its severity affect cardiac structure and function in adolescents. METHODS: We enrolled 181 adolescents aged 13-19, newly diagnosed with depression at our Mental Health Center (December 2024-December 2025), and 45 healthy controls. Conventional echocardiography and two-dimensional speckle-tracking (2D- STE) assessed cardiac anatomy, systolic/diastolic function, and strain parameters. Differences between groups and correlations with depression severity were analyzed. RESULTS: The depression group showed significant differences in left ventricular ejection fraction (LVEF), left ventricular fractional shortening (FS), and left ventricular end-systolic volume (LVESV) compared to controls (all p < 0.05). LVEF, FS, tricuspid annular systolic velocity (S'), E/e' ratio, and left atrial strain all correlated with depression severity (all p < 0.05). The S' values in the mild depression group were significantly higher than those in the control group, as well as those in the moderate and severe depression groups (p < 0.05). E/e' was higher in moderate depression than in mild and severe cases (p < 0.05). CONCLUSIONS: Adolescents who are depressed may see changes in heart contractile function at an early period. In patients with depression, echocardiography provides a non-invasive examination of heart structure and function. It provides an image reference for real-time clinical monitoring and risk prediction by performing objective analysis using quantitative parameters.