Long-term myocardial deformation abnormalities and biomarker associations in pediatric myopericarditis: a speckle-tracking echocardiographic study

Background and objectives Subclinical myocardial deformation abnormalities may be detectable during long-term follow-up in pediatric patients with a history of myopericarditis despite apparently normal conventional echocardiographic findings. This study aimed to comprehensively evaluate long-term myocardial deformation abnormalities using speckle-tracking echocardiography and to assess their associations with acute-phase inflammatory and cardiac biomarkers. Methods Thirty pediatric patients with a history of myopericarditis and 22 age- and sex-matched healthy controls were included. Acute-phase clinical, laboratory, electrocardiographic, and echocardiographic data were retrospectively collected. At long-term follow-up, comprehensive echocardiographic evaluation including tissue Doppler imaging and speckle-tracking–derived longitudinal and circumferential strain analysis was prospectively performed. Associations between acute-phase biomarkers and long-term echocardiographic findings were analyzed. Results At a mean follow-up of 32.8 ± 12.0 months, patients demonstrated significantly reduced global longitudinal strain (−12.43 ± 6.67% vs. −17.77 ± 1.94%, p < 0.001) and global circumferential strain (−16.04 ± 12.50% vs. −25.14 ± 4.73%, p = 0.002) compared with controls despite largely preserved conventional systolic function. Segmental longitudinal and circumferential strain parameters were also impaired, accompanied by increased time-to-peak strain dispersion. Higher neutrophil-to-lymphocyte ratio and systemic immune-inflammation index values correlated with less negative global longitudinal strain values, while CRP correlated with impaired global circumferential strain. Conclusions Pediatric patients with a history of myopericarditis may exhibit subclinical myocardial deformation abnormalities at long-term follow-up despite apparently preserved conventional echocardiographic findings. Speckle-tracking echocardiography may provide incremental value for detecting subtle myocardial deformation abnormalities beyond conventional systolic assessment. Exploratory associations were observed between acute-phase inflammatory biomarkers and long-term myocardial deformation parameters; however, larger prospective studies are needed to clarify whether these findings have causal or clinical significance.