Left Ventricular Strain in Neonates using 2-dimensional speckle
tracking: Normal range and relation with bi-plan Ejection fraction.
Abstract
Objectives: Echocardiographic assessment of Left ventricular
systolic function is traditionally being performed by estimation of
fractional shortening and Ejection fraction. Speckle tracking
echocardiography (STE) is a promising tool for assessment of myocardial
function. The aim of this study is to evaluate the global longitudinal
strain (GLS) using 2D-STE in healthy neonates to establish normal
reference ranges. Method: it is a retrospective study through
an analysis of transthoracic echocardiogram of normal healthy neonates.
We enrolled all neonates in our institution from 1 st
January 2021 to 28 th February 2021. 2-D STE was used
to assess left ventricular global longitudinal strain from the apical
views. Results: 185 neonates were enrolled. Mean value for left
ventricle GLS (%) was -19.9 ± 1.2, GLS-derived ejection fraction (%)
was 60.0 ± 2.7; while the left ventricle ejection fraction by biplane
Simpson’s method (%) was 61.0 ± 3. There is a good positive correlation
between the Left Ventricle EF by biplane Simpson’s method and EF by 2-D
STE, which was statistically significant ( r = 0.294, n =
102, p=0.003). Apical 4-chamber longitudinal strain and strain
derived EF is significantly correlated with GLS and bi-plan EF
respectively. Conclusion: 2-STE is feasible technique for
analyzing newborn myocardial systolic function. The normal range of GLS
in neonates is not much different than reported for the pediatric. There
is a good positive correlation between the Left Ventricle EF by 2-D STE
and EF by biplane method.