Assessment of Cardiac Function in Children by Strain Imaging and its Correlation with Conventional Echocardiographic Parameter

Background: The objectives of this study were to find out of normal reference value for age-dependent longitudinal strain values in children and find its correlation with conventional echocardiographic parameters. Methods: In total, 100 healthy normal children aged between 2 and 15 years were enrolled and divided into three age groups, namely, 2-5 years. 5-10 years, and 10-15 years. Using the GE Vivid 7 ultrasound platform with 4 or 7 MHz probes, both LV and RV global longitudinal strains and conventional echocardiographic parameters were acquired. Results: In normal healthy children, left ventricular GLS values were -20.10 to -19.68 (mean: -19.89), -21.93 to 21.02 (mean: 21.48), and -20.87 to -20.41 (mean: -20.64)) in children aged 2-5 years, 5-10 years, and 10-15 years and right ventricular GLS values were -16.80 to -16.44 (mean: -16.62), -27.85 to -27.27 (mean: -27.56), -28.44 to -27.93 (mean: -28.19) in the above three groups, respectively. No significant increase was noted in the left ventricular strain value from basal to the apical segment from age group 2 years to 15 years and no gender differences were seen. None of the conventional echocardiographic parameters commonly used to assess the left or right ventricular systolic function had a significant correlation with LVGLS and RVGLS. Conclusions: The mean LVGLS values were -19.89, -21.48, and -20.64 and RVGLS were -16.62, -27.56. and -28.19 in healthy normal children aged 2-5 years, 5-10 years, and 10-15 years, respectively, and conventional echocardiographic parameters did not have any significant correlation with these values.