Myocardial deformation in children post cardiac surgery, a cross-sectional prospective study.

Mohammad Ahmad Hassan, Ali Al-Akhfash, Yasser Bhat, Abdullah Alqwaiee, Mohammed Abdulrashed, Saad Saleh Almarshud, Abdulrahman Almesned
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Abstract

Background: Myocardial deformation by speckle tracking echocardiography provides valuable information on the left ventricular function. The study aims to assess myocardial deformation in terms of left ventricular strain as an indicator of myocardial function in children after cardiac surgery at outpatient follow-up visits.

Methods: The study design was a prospective observational cross-sectional study that included pediatric patients after biventricular cardiac surgery during the postoperative follow-up visits in the outpatient department. In addition to conventional echocardiographic examination, two-dimensional speckle tracking echocardiography was done to evaluate myocardial deformation in terms of left ventricular strain. Echocardiographic measurements were done offline and were compared to published reference normal values for age. Study subjects were divided according to age at follow-up into four groups (1 month-1 year, 1-2 years, 2-5 years, and 5-11 years).

Results: Over ten months, 100 patients (64 males and 36 females) were included in the study. The median age was 30.8 months (IQR 12.8-65.3 months), the median weight was 11.7 kg (IQR 8-17 kg) and the median duration after surgery was 7.3 months (IQR 3.2-30.8 months). Longitudinal strain values were significantly (p < 0.001) lower than reference values for different age groups. Global circumferential strain showed no significant difference from the reference values. The duration after surgery had a statistically significant effect on longitudinal strain values, with improvement of the strain values with increasing intervals after surgery.

Conclusion: Using myocardial deformation method to evaluate cardiac function may detect underlying cardiac function abnormalities even with normal traditional functional parameters, which could have implications for patient management and follow-up.

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心脏手术后儿童心肌变形的横断面前瞻性研究。
背景:通过斑点追踪超声心动图检查心肌变形可提供有关左心室功能的宝贵信息。本研究旨在评估心脏手术后儿童在门诊随访时以左心室应变作为心肌功能指标的心肌变形情况:研究设计为前瞻性观察横断面研究,包括双心室心脏手术后在门诊部进行术后随访的儿童患者。除常规超声心动图检查外,还进行了二维斑点追踪超声心动图检查,以评估左心室应变方面的心肌变形。超声心动图测量在离线状态下进行,并与已公布的年龄参考正常值进行比较。研究对象根据随访时的年龄分为四组(1 个月至 1 年、1 至 2 年、2 至 5 年和 5 至 11 年):在十个月的时间里,共有 100 名患者(64 名男性和 36 名女性)参与了研究。中位年龄为 30.8 个月(IQR 12.8-65.3 个月),中位体重为 11.7 千克(IQR 8-17 千克),中位术后持续时间为 7.3 个月(IQR 3.2-30.8 个月)。纵向应变值明显(P使用心肌变形法评估心脏功能,即使传统功能参数正常,也能发现潜在的心脏功能异常,这对患者管理和随访有一定的意义。
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