Hostname: page-component-586b7cd67f-dlnhk Total loading time: 0 Render date: 2024-11-27T10:39:07.769Z Has data issue: false hasContentIssue false
  • English
  • Français

Echocardiographic assessment of left ventricular dyssynchrony in Egyptian children with congestive heart failure due to dilated cardiomyopathy

Published online by Cambridge University Press:  02 October 2014

Mohammed A. Al-Biltagi Open the ORCID record for Mohammed A. Al-Biltagi [Opens in a new window] ,
Osama Abd Rab Elrasoul Tolba ,
Heba El Mahdy ,
Amr Donia  and
Shaimaa Elbanna
Mohammed A. Al-Biltagi*
Affiliation:
Pediatric Department, Faculty of Medicine, Tanta University, Tanta, Egypt
Osama Abd Rab Elrasoul Tolba
Affiliation:
Pediatric Department, Faculty of Medicine, Tanta University, Tanta, Egypt
Heba El Mahdy
Affiliation:
Pediatric Department, Faculty of Medicine, Tanta University, Tanta, Egypt
Amr Donia
Affiliation:
Pediatric Department, Faculty of Medicine, Tanta University, Tanta, Egypt
Shaimaa Elbanna
Affiliation:
Pediatric Department, Faculty of Medicine, Tanta University, Tanta, Egypt
*
Correspondence to: M. A. Al-Biltagi, MD, PhD (Pediatric), Pediatric Cardiology Unit, Department of Pediatrics, Faculty of Medicine, Tanta University, Tanta, Egypt. Tel: 0020102209797; Fax: 020402213543; E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective: To evaluate the presence of cardiac dyssynchrony in Egyptian children with congestive heart failure due to dilated cardiomyopathy. Materials and methods: A total of 30 children with congestive cardiac failure due to dilated cardiomyopathy and 30 healthy age-matched controls were examined with conventional echocardiography, tissue Doppler, and speckle tracking imaging. Results: Conventional Doppler echocardiography demonstrated significant left ventricular systolic and diastolic dysfunction in the patient group. Tissue Doppler showed significant decrease in S-wave velocity and E'/A' ratio, and prolonged isovolumic contraction and relaxation times of mitral annulus as well as significant prolongation in mean difference between time-to-peak systolic strain of the basal septal and basal lateral segments in the patient group compared with the control group (p<0.005). Speckle tracking imaging demonstrated significant prolongation in mean difference between time-to-peak systolic strain of anteroseptal and posterior segments in both circumferential and radial strain analysis in the patient group than in the control group (p<0.005). It also demonstrated significant prolongation in the mean difference between time-to-peak systolic strain of the basal septal and basal lateral segments in longitudinal strain analysis in the patient group than in the control group (p<0.005). A significant increase in the standard deviation of time-to-peak strain, as a marker of increased intra-ventricular dyssycnrony, was present in the patient group compared with the control group (p=0.008). Conclusion: Children with congestive heart failure due to dilated cardiomyopathy usually suffer from significant intra-ventricular dyssynchrony. Tissue Doppler imaging and speckle tracking imaging strain analysis are helpful tools to detect the presence of cardiac dyssynchrony.

Keywords

Dilated cardiomyopathycardiac dyssynchronychildrenspeckle tracking imagingtissue Doppler imaging
Type
Original Articles
Information
Cardiology in the Young , Volume 25 , Issue 6 , August 2015 , pp. 1173 - 1181
Copyright
© Cambridge University Press 2014 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Patel, AR, Shaddy, RE. Role of β-blocker therapy in pediatric heart failure. Ped Health 2010; 4: 45–58.Google Scholar
2. Burkhardt, JD, Wilkoff, BL. Interventional electrophysiology and cardiac resynchronization therapy: delivering electrical therapies for heart failure. Circulation 2007; 115: 2208–2220.Google Scholar
3. Iuliano, S, Fisher, SG, Karasik, PE, Fletcher, RD, Singh, SN. Department of veterans affairs survival trial of antiarrhythmic therapy in congestive heart failure. QRS duration and mortality in patients with congestive heart failure. Am Heart J 2002; 143: 1085–1091.Google Scholar
4. Baldasseroni, S, Opasich, C, Gorini, M, et al. Left bundle-branch block is associated with increased 1-year sudden and total mortality rate in 5517 outpatients with congestive heart failure: a report from the Italian network on congestive heart failure. Am Heart J 2002; 143: 398–405.Google Scholar
5. Shamim, W, Francis, DP, Yousufuddin, M, et al. Intraventricular conduction delay: a prognostic marker in chronic heart failure. Int J Cardiol 1999; 70: 171–178.Google Scholar
6. Bleeker, GB, Bax, JJ, Steendijk, P, Schalij, MJ, van der Wall, EE. Left ventricular dyssynchrony in patients with heart failure: pathophysiology, diagnosis and treatment. Nat Clin Pract Cardiovasc Med 2006; 3: 213–219.Google Scholar
7. Zhang, Q, Yu, C. Clinical implication of mechanical dyssynchrony in heart failure. J Cardiovasc Ultrasound 2012; 20: 117–123.Google Scholar
8. Hsu, DT, Pearson, GD. Heart failure in children: Part I: history, etiology, and pathophysiology. Circ Heart Fail 2009; 2: 63–70.Google Scholar
9. Kaku, K, Takeuchi, M, Tsang, W, et al. Age-related normal range of left ventricular strain and torsion using three-dimensional speckle-tracking echocardiography. J Am Soc Echocardiogr 2014; 27: 55–64.Google Scholar
10. Al-Biltagi, M, Serag, AR, Hefidah, MM, Mabrouk, MM. Evaluation of cardiac functions with Doppler echocardiography in children with down syndrome and anatomically normal heart. Cardiol Young 2013; 23: 174–180.Google Scholar
11. Picard, MH, Adams, D, Bierig, SM, et al. American Society of Echocardiography recommendations for quality echocardiography laboratory operations. J Am Soc Echocardiogr 2011; 24: 1–10.Google Scholar
12. Lopez, L, Colan, SD, Frommelt, PC, et al. Recommendations for quantification methods during the performance of a pediatric echocardiogram: a report from the Pediatric Measurements Writing Group of the American Society of Echocardiography Pediatric and Congenital Heart Disease Council. J Am Soc Echocardiogr 2010; 23: 465–495; quiz 576–577.CrossRefGoogle ScholarPubMed
13. Eidem, BW, McMahon, CJ, Cohen, RR, et al. Impact of cardiac growth on Doppler tissue imaging velocities: a study in healthy children. J Am Soc Echocardiogr 2004; 17: 212–221.Google Scholar
14. Delgado, V, Ypenburg, C, van Bommel, RJ, et al. Assessment of left ventricular dyssynchrony by speckle tracking strain imaging, comparison between longitudinal, circumferential, and radial strain in cardiac resynchronization therapy. J Am Coll Cardiol 2008; 51: 1944–1952.Google Scholar
15. Suffoletto, MS, Dohi, K, Cannesson, M, Saba, S, Gorcsan, J 3rd. Novel speckle-tracking radial strain from routine black-and-white echocardiographic images to quantify dyssynchrony and predict response to cardiac resynchronization therapy. Circulation 2006; 113: 960–968.Google Scholar
16. Perk, G, Tunick, PA, Kronzon, I. Non-Doppler two dimensional strain imaging by echocardiography – from technical considerations to clinical applications. J Am Soc Echocardiogr 2007; 20: 234–243.Google Scholar
17. Bleeker, GB, Bax, JJ, Fung, JW, et al. Clinical versus echocardiographic parameters to assess response to cardiac resynchronization therapy. Am J Cardiol 2006; 97: 260–263.Google Scholar
18. Marwick, TH, Case, C, Leano, R, et al. Use of tissue Doppler imaging to facilitate the prediction of events in patients with abnormal left ventricular function by dobutamine echocardiography. Am J Cardiol 2004; 93: 142–146.Google Scholar
19. Ho, CY, Sweitzer, NK, McDonough, B, et al. Assessment of diastolic function with Doppler tissue imaging to predict genotype in preclinical hypertrophic cardiomyopathy. Circulation 2002; 105: 2992–2997.Google Scholar
20. Bax, JJ, Ansalone, G, Breithardt, OA, et al. Echocardiographic evaluation of cardiac resynchronization therapy: ready for routine clinical use? A critical appraisal. J Am Coll Cardiol 2004; 44: 1–9.Google Scholar
21. Delgado, V, Ypenburg, C, van Bommel, RJ, et al. Assessment of left ventricular dyssynchrony by speckle tracking strain imaging comparison between longitudinal, circumferential, and radial strain in cardiac resynchronization therapy. J Am Coll Cardiol 2008; 51: 1944–1952.Google Scholar
22. Sutherland, GR, Di Salvo, G, Claus, P, D’hooge, J, Bijnens, B. Strain and strain rate imaging: a new clinical approach to quantifying regional myocardial function. J Am Soc Echocardiogr 2004; 17: 788–802.Google Scholar
23. Andrikopoulos, GK, Tzeis, S, Kolb, C, et al. Correlation of mechanical dyssynchrony with QRS duration measured by signal-averaged electrocardiography. Ann Noninvasive Electrocardiol 2009; 14: 234–241.Google Scholar
24. Gokhale, J, Husain, N, Nicholson, L, Texter, KM, Zaidi, AN, Cua, CL. QRS duration and mechanical dyssynchrony correlations with right ventricular function after fontan procedure. J Am Soc Echocardiogr 2013; 26: 154–159.Google Scholar
25. Leong, DP, Chakrabarty, A, Shipp, N, et al. Effects of myocardial fibrosis and ventricular dyssynchrony on response to therapy in new-presentation idiopathic dilated cardiomyopathy: insights from cardiovascular magnetic resonance and echocardiography. Eur Heart J 2012; 33: 640–648.Google Scholar