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| Evaluation of Left Ventricular Systolic Function in Children with Left Ventricular Noncompaction by Two-dimensional Speckle Tracking Imaging |
| HU Yuan,LIU Qian-jun,XIAO Li-miao,et al |
| Department of Ultrasound,Hu'nan Children's Hospital,Changsha 410007,China |
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Abstract 【Objective】To investigate the value of two-dimensional speckle tracking imaging in the assessment of left ventricular systolic function in children with left ventricular noncompaction (LVNC). 【Methods】 A total of 27 patients with clinically diagnosed LVNC whose left ventricular systolic function were improved after standard anti-heart failure treatment were collected as the observation group. In addition, 27 healthy children were selected as the control group. The routine echocardiographic function parameters was examined firstly, then the left ventricular global longitudinal strain (GLS), global circumferential strain (GCS) and segmental longitudinal strain (LS) and circumferential strain (CS) were evaluated by two-dimensional speckle tracking imaging. The above parameters between LVNC children (pre-treatment and post-treatment) and the control group were compared. 【Results】After treatment, LVESV (left ventricular end-systolic volume) and LVEDD (Left ventricular end-diastolic diameter) in LVNC children were lower than those before treatment, while LVEF (left ventricular ejection fraction) was higher than that before treatment in LVNC children (all P<0.05). There were no significant differences in left ventricular end-diastolic volume (LVEDV) and LVEDD between the observation group post-treatment and the control group (P>0.05), while LVEF was significantly lower than the control group. After treatment, the left ventricular GLS, LS, GCS and CS of LVNC children were higher than those before treatment (all P<0.05). Compared to the control group, GLS, GCS, CS and 4 apical segments of LS decreased in post-treatment LVNC children (P<0.05),however, there was no significant difference of LS for the remaining segments between the control group and LVNC children post-treatment (P>0.05). In the post-treatment group of LVNC children, 25 patients had LVEF≥50% and the absolute value of LVEF increased by at least ≥10% compared with baseline. There were only 2 patients with LVNC had LVEF<50% and the absolute value of LVEF increased by <10% compared with baseline. During the follow-up period, 25 patients in the observation group kept LVEF ≥ 50% and the absolute value of LVEF increased by at least ≥ 10% compared with baseline; those two LVNC children with LVEF < 50% had no significant changes of the absolute value of LVEF compared with that before treatment. According to the modified ROSS classification, the cardiac function of the 27 HVNC children pre-treatment were grade Ⅳ. After treatment, the cardiac function of 19 children were grade II, 6 children were grade I, and 2 children were grade Ⅳ.【Conclusion】Left ventricular systolic function of children with LVNC get improved after standard anti-heart failure treatment, even the contraction of left ventricle segment does not return to normal level. Two-dimensional speckle tracking imaging can evaluate the left ventricular global and regional myocardial function pre- and post-treatment in children with LVNC, which provides useful reference for diagnosis and treatment of HVNC.
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Received: 01 August 2019
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2019, Vol. 36 
