Interobserver Agreement and Reference Intervals for Biventricular Myocardial Deformation in Full-Term, Healthy Newborns: A 2D Speckle-Tracking Echocardiography-Based Strain Analysis

Int J Environ Res Public Health. 2022 Jul 15;19(14):8620. doi: 10.3390/ijerph19148620.

Abstract

Data regarding reference intervals for strain parameters derived from 2D speckle-tracking echocardiography in full-term newborns are limited and still under development. Our objectives were to establish the level of reproducibility and reference intervals in assessing myocardial function using 2D speckle-tracking echocardiography for longitudinal and regional strain measurements. A total of 127 full-term newborns were examined to be included in the study, of which 103 were analyzed. We used two-dimensional acquisitions from apical four-chamber view of both ventricles and analyzed the autostrain function offline. We obtained interobserver agreement between the two observers ranging from good to excellent for all speckle-tracking parameters except for the strain of the medial portion of the left ventricle (LV) lateral wall and the strain measured on the basal portion of the inter-ventricular septum, which reflected a fair interobserver reproducibility (ICC = 0.52, 95% IC: 0.22-0.72 and ICC = 0.43, 95% IC: 0.12-0.67, respectively). The reference values obtained for the LV peak longitudinal strain were between -24.65 and -14.62, those for the right ventricle (RV) free wall were from -28.69 to -10.68, and those for the RV global four-chamber were from -22.30 to -11.37. In conclusion, two-dimensional peak longitudinal LV and RV strains are reproducible with good to excellent agreement and may represent a possible alternative for the cardiac assessment of healthy newborns in the clinical practice.

Keywords: echocardiography; myocardial strain; newborn; speckle tracking.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Echocardiography* / methods
  • Heart Ventricles* / diagnostic imaging
  • Humans
  • Infant, Newborn
  • Observer Variation
  • Reference Values
  • Reproducibility of Results

Grants and funding

This research was supported by University of Medicine, Pharmacy, Science, and Technology “George Emil Palade” of Târgu Mureș, Research Grant number 10126/4/17.12.2020.