Echocardiographic evaluation of left ventricle mechanical parameters in infants of the first year of life
Published 2017-11-22
Keywords
- left ventricle,
- strain,
- strain rate,
- twisting,
- untwisting
- torsion ...More
How to Cite
Copyright (c) 2017 Sinelnikov Yu.S., Orekhova E.N., Matanovskaya T.V., Polevshikova M.A.

This work is licensed under a Creative Commons Attribution 4.0 International License.
Abstract
Aim. The study focused on the analysis of the measurement range of left ventricle mechanics (strain, strain rate, rotation, rotation rate, twisting, untwisting, torsion) in healthy infants of the first year of life to obtain their baseline values.
Methods. The study included 125 healthy infants aged 5 days to 12 months (average 5.9±3.9 months. The Аcuson S 2000 machine (Siemens Medical Systems, Mountain View, CA, USA) was used to perform echocardiography. The indicators of left ventricle longitudinal strain (%) and strain rate (s–1), radial strain and strain rate (% and s–1), circumferential strain and strain rate (% and s–1), basal and apical rotation in systole and diastole (°) and rotation rate (°/s), twisting (°), untwisting (°), twisting and unwinding rate (°/s) and torsion (°/cm) were measured and analyzed.
Results. It was found out that the values of the longitudinal strain and strain rate inversely correlate with the pumping function (stroke volume index) and diastolic function (filling pressures and the untwisting rate). The parameters of the circular and radial strain tended to depend on the left ventricle mass index, interventricular septum/left ventricle posterior wall thicknesses. Left ventricle twisting and untwisting would increase in healthy infants from the newborn period to the first year of life. Left ventricle torsion range was determined by the twist values and not by left ventricular geometry.
Conclusion. The obtained data on the values of longitudinal, circumferential and radial left ventricle strain and strain rate can be used as reference ranges to evaluate the mechanical left ventricular function in infants of the first year of life.
Received 27 January 2017. Accepted 15 June 2017.
Funding: The study did not have sponsorship.
Conflict of interest: The authors declare no conflict of interest.
Author contributions
Conception and study design: Yu.S. Sinelnikov, E.N. Orekhova
Data collection and analysis: M.A. Polevshikova, T.V. Matanovskaya
Drafting the article: E.N. Orekhova, M.A. Polevshikova
Critical revision of the article: Yu.S. Sinelnikov, E.N. Orekhova
Final approval of the version to be published: Yu.S. Sinelnikov, E.N. Orekhova, T.V. Matanovskaya, M.A. Polevshikova
References
- Lopes L., Colan S.D., Frommelt P.C., Ensing G.J., Kendall K., Younoszai A.K., Lai W.W., Geva T. 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(5):465-95. PMID: 20451803. http://dx.doi.org/10.1016/j.echo.2010.03.019
- Sehgal A., Wong F., Menahem S. Speckle tracking derived strain in infants with severe perinatal asphyxia: a comparative case control study. Cardiovasc Ultrasound. 2013;11:34. PMID: 24229323. http://dx.doi.org/10.1186/1476-7120-11-34
- Van der Ende J., Vázquez Antona C.A., Erdmenger Orellana J., Romero Cárdenas Á., Roldan F.J., Vargas Barrón J. Left ventricular longitudinal strain measured by speckle tracking as a predictor of the decrease in left ventricular deformation in children with congenital stenosis of the aorta or coarctation of the aorta. Ultrasound Med Biol. PMID: 23643058. 2013;39(7):1207-14. http://dx.doi.org/10.1016/j.ultrasmedbio.2013.02.015
- Jashari Н., Rydberg А., Ibrahimi Р., Bajraktari G., Kryeziu L., Jashari F., Henein M.Y. Normal ranges of left ventricular strain in children: a meta-analysis. Cardiovasc Ultrasound. 2015;13:37. PMID: 26250696. http://dx.doi.org/10.1186/s12947-015-0029-0
- Al-Naami G.H. Torsion of young hearts: a speckle tracking study of normal infants, children, and adolescents. Eur J Echocardiogr. 2010;11(10):853-62. PMID: 20591878. http://dx.doi.org/10.1093/ejechocard/jeq078
- Lang R.M., Badano L.P., Mor-Avi V., Afilalo J., Armstrong A., Ernande L., Flachskampf F.A., Foster E., Goldstein S.A., Kuznetsova T., Lancellotti P., Muraru D., Picard M.H., Rietzschel E.R., Rudski L., Spencer K.T., Tsang W., Voigt J.U. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr. 2015;28(1):1-39. PMID: 25559473.
- Patey O., Carvalho J.S., Thilaganathal B. Fetal and neonatal left ventricular torsion in normal, growth-restricted and diabetic pregnancies. Ultrasound in Obstetrics and Gynecology. 2016;48(I S1):68-9. http://dx.doi.org/10.13140/RG.2.2.34731.03366
- Breatnach C.R., Levy P.T., James A.T., Franklin O., El-Khuffash A. Novel echocardiography methods in the functional assessment of the newborn heart. Neonatology. 2016;110(4):248-60. PMID: 27287615. http://dx.doi.org/10.1159/000445779
- Zhang L., Zhang J., Han W., Gao J., He L., Yang Y., Yin P., Xie M., Ge S. Three-dimensional rotation, twist and torsion analyses using real-time 3D speckle tracking imaging: feasibility, reproducibility, and normal ranges in pediatric population. PLoS ONE. 2016;11(7):e0158679. PMID: 27427968. http://dx.doi.org/10.1371/journal.pone.0158679
- Notomi Y., Srinath G., Shiota T., Martin-Miklovic M.G., Beachler L., Howell K., Oryszak S.J., Deserranno D.G., Freed A.D., Greenberg N.L., Younoszai A., Thomas J.D. Maturational and adaptive modulation of left ventricular torsional biomechanics: Doppler tissue imaging observation from infancy to adulthood. Circulation. 2006;113(21):2534-41. PMID: 16717154. http://dx.doi.org/10.1161/CIRCULATIONAHA.105.537639
- Voigt J.U., Pedrizzetti G., Lysyansky P., Marwick T.H., Houle H., Baumann R., Pedri S., Ito Y., Abe Y., Metz S., Song J.H., Hamilton J., Sengupta P.P., Kolias T.J., d'Hooge J., Aurigemma G.P., Thomas J.D., Badano L.P. Definitions for a common standard for 2D speckle tracking echocardiography: consensus document of the EACVI/ASE/Industry Task Force to standardize deformation imaging. Eur Heart J Cardiovasc Imaging. 2015;16(1):1-11. PMID: 25525063. http://dx.doi.org/10.1093/ehjci/jeu184
- Schubert U., Muller M., Norman M., Abdul-Khaliq H. Transition from fetal to neonatal life: changes in cardiac function assessed by speckle-tracking echocardiography. Early Hum Dev. 2013;89(10):803-8. PMID: 23948155. http://dx.doi.org/10.1016/j.earlhumdev.2013.06.009
- Jashari H., Rydberg A., Ibrahimi P., Bajraktari G., Henein M.Y. Left ventricular response to pressure afterload in children: aortic stenosis and coarctation: a systematic review of the current evidence. Int J Cardiol. 2015;178:203-9. PMID: 25464254. http://dx.doi.org/10.1016/j.ijcard.2014.10.089