Assessment of myocardial strain in children with risk factors for atherosclerosis with use of 3D speckle tracking echocardiography

Echocardiography. 2018 Apr;35(4):487-493. doi: 10.1111/echo.13806. Epub 2018 Feb 4.

Abstract

Background: The known risk factors for atherosclerosis such as dyslipidemia, hypertension, obesity, and fasting hyperglycemia are associated with subclinical myocardial dysfunction. We assessed myocardial strain in children who had risk factors for atherosclerosis with use of 3D speckle tracking echocardiography (3DSTE).

Methods: A total of 340 eligible children (mean age [±SD]: 9.5 [±1.9] years; range, 7.1-12.2; 189 males, 151 females). Levels of serum cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), fasting blood glucose (FBG), systolic blood pressure (SBP), diastolic blood pressure (DBP), and body mass index (BMI) were investigated. The parameters of left ventricular (LV) myocardial strain including global longitudinal strain (GLS), global circumferential strain (GCS), and global radial strain (GRS) were measured with use of real time 3DSTE.

Results: Left ventricular (LV) global longitudinal strain and global circumferential strain in the groups with isolated dyslipidemia, isolated hypertension, isolated obese/overweight, and combination groups were lower than those in healthy controls (P < .01 for all). Global longitudinal strain (GLS) and GCS showed a negative correlation with the respective risk factors (TG, TC, and LDL-C; SBP and DBP; weight and BMI) (P < .05 for all). Multiple stepwise regression analysis showed a significant negative correlation of GLS and GCS with BMI, TC, TG, and SBP. The degree of myocardial strain aggravated significantly with increase in the number of risk factors in an individual subject.

Keywords: global circumferential strain; global longitudinal strain; left ventricular; myocardial strain; three-dimensional speckle tracking echocardiography.

MeSH terms

  • Atherosclerosis / complications
  • Atherosclerosis / physiopathology*
  • Child
  • Dyslipidemias / complications
  • Dyslipidemias / physiopathology
  • Echocardiography, Three-Dimensional / methods*
  • Female
  • Heart / diagnostic imaging
  • Heart / physiopathology*
  • Heart Ventricles / diagnostic imaging
  • Heart Ventricles / physiopathology
  • Humans
  • Hyperglycemia / complications
  • Hyperglycemia / physiopathology
  • Hypertension / complications
  • Hypertension / physiopathology
  • Male
  • Pediatric Obesity / complications
  • Pediatric Obesity / physiopathology
  • Reproducibility of Results
  • Risk Factors
  • Ventricular Dysfunction, Left / complications
  • Ventricular Dysfunction, Left / diagnostic imaging
  • Ventricular Dysfunction, Left / physiopathology