TY - JOUR
T1 - Distribution of strain patterns in children with dilated cardiomyopathy
AU - den Boer, Susanna L.
AU - du Marchie Sarvaas, Gideon J.
AU - Klitsie, Liselotte M.
AU - van Iperen, Gabriëlle G.
AU - Tanke, Ronald B.
AU - Helbing, Willem A.
AU - Backx, Ad P.C.M.
AU - Rammeloo, Lukas A.J.
AU - Dalinghaus, Michiel
AU - ten Harkel, Arend D.J.
PY - 2017/6/1
Y1 - 2017/6/1
N2 - 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.
AB - 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.
KW - dilated cardiomyopathy
KW - myocardial strain
UR - http://www.scopus.com/inward/record.url?scp=85019031330&partnerID=8YFLogxK
U2 - https://doi.org/10.1111/echo.13548
DO - https://doi.org/10.1111/echo.13548
M3 - Article
C2 - 28480564
SN - 0742-2822
VL - 34
SP - 881
EP - 887
JO - Echocardiography
JF - Echocardiography
IS - 6
ER -