Skip to main content Accessibility help
×
Home

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

  • Mohammed A. Al-Biltagi (a1), Osama Abd Rab Elrasoul Tolba (a1), Heba El Mahdy (a1), Amr Donia (a1) and Shaimaa Elbanna (a1)...

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.

Copyright

Corresponding author

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: mbelrem@hotmail.com

References

Hide All
1. Patel, AR, Shaddy, RE. Role of β-blocker therapy in pediatric heart failure. Ped Health 2010; 4: 4558.
2. Burkhardt, JD, Wilkoff, BL. Interventional electrophysiology and cardiac resynchronization therapy: delivering electrical therapies for heart failure. Circulation 2007; 115: 22082220.
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: 10851091.
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: 398405.
5. Shamim, W, Francis, DP, Yousufuddin, M, et al. Intraventricular conduction delay: a prognostic marker in chronic heart failure. Int J Cardiol 1999; 70: 171178.
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: 213219.
7. Zhang, Q, Yu, C. Clinical implication of mechanical dyssynchrony in heart failure. J Cardiovasc Ultrasound 2012; 20: 117123.
8. Hsu, DT, Pearson, GD. Heart failure in children: Part I: history, etiology, and pathophysiology. Circ Heart Fail 2009; 2: 6370.
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: 5564.
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: 174180.
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: 110.
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: 465495; quiz 576–577.
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: 212221.
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: 19441952.
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: 960968.
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: 234243.
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: 260263.
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: 142146.
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: 29922997.
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: 19.
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: 19441952.
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: 788802.
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: 234241.
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: 154159.
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: 640648.

Keywords

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

  • Mohammed A. Al-Biltagi (a1), Osama Abd Rab Elrasoul Tolba (a1), Heba El Mahdy (a1), Amr Donia (a1) and Shaimaa Elbanna (a1)...

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed