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Distribution of strain patterns in children with dilated cardiomyopathy
Author(s) -
Boer Susanna L.,
Marchie Sarvaas Gideon J.,
Klitsie Liselotte M.,
Iperen Gabriëlle G.,
Tanke Ronald B.,
Helbing Willem A.,
Backx Ad P.C.M.,
Rammeloo Lukas A.J.,
Dalinghaus Michiel,
Harkel Arend D.J.
Publication year - 2017
Publication title -
echocardiography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.404
H-Index - 62
eISSN - 1540-8175
pISSN - 0742-2822
DOI - 10.1111/echo.13548
Subject(s) - medicine , cardiology , ventricle , dilated cardiomyopathy , reproducibility , clinical endpoint , heart failure , cardiomyopathy , heart transplantation , randomized controlled trial , statistics , mathematics
Objectives This study aimed to evaluate the predicting value of quantitative and qualitative dyssynchrony parameters as assessed by two‐dimensional speckle tracking echocardiography ( STE ) on outcome in children with dilated cardiomyopathy ( DCM ). Furthermore, the reproducibility of these parameters was investigated. Background In previous studies in adults with heart failure, several dyssynchrony parameters have been shown to be a valuable predictor of clinical outcome. Methods This multicenter, prospective study included 75 children with DCM and 75 healthy age‐matched controls. Using STE , quantitative (time to global peak strain and parameters describing intraventricular time differences) and qualitative dyssynchrony parameters (pattern analysis) of the apical four‐chamber, three‐chamber, two‐chamber views, and the short axis of the left ventricle were assessed. Cox regression was used to identify risk factors for the primary endpoints of death or heart transplantation. Inter‐observer and intra‐observer variability were described. Results During a median of 21 months follow‐up, 10 patients (13%) reached an endpoint. Although quantitative dyssynchrony measures were higher in patients as compared to controls, the inter‐observer and intra‐observer variability were high. Pattern analysis showed mainly reduced strain, instead of dyssynchronous patterns. Conclusions In this study, quantitative dyssynchrony parameters were not reproducible, precluding their use in children. Qualitative pattern analysis showed predominantly reduced strain, suggesting that in children with DCM dyssynchrony may be a minor problem.