Clinical Implication of Torsion and Strain Using 2D Speckle Tracking Echocardiagraphy in Congenital and Pediatric Population

Abstract

Due to advance of pediatric cardiac surgery during past several centuries, survival started to increase with currently a survival rate into adulthood of many patients born with a congenital heart defect (CHD). Although long-term survival seems promising, follow-up is still complicated in corrected CHD patients characterized by a varying degree of impairment of ventricular performance. Furthermore it is not enough and sometime impossible to evaluate the ventricular function with conventional method in the patients with various morphologic ventricles in these patients. Torsion provides new insight into both systolic and diastolic function compared with conventional methods. Although left ventricular (LV) torsion and strain are important components of LV function in adult population, there are few studies in children and adolescents. In this issue of the Journal, Kim et al., their study using speckle-tracking echocardiography demonstrated the rotation and torsion data in normal children between 2–16 years of the age. They also tried to compare the difference of rotation and torsion between the preschool group and the school group by dividing the patients according to age. As authors mentioned, they could not achieve meaningful difference between two age groups or powerful normal data because of small sample size. However this investigation itself seems to be meaningful attempt in congenital and pediatric cardiologic field. In adult population, there is clear left ventricle twist because of opposite rotational motional motion of base and apex, whereas in children both segments rotate in the same direction but for different amounts and with a longer deformational depISSN 1975-4612/ eISSN 2005-9655 Copyright © 2016 Korean Society of Echocardiography www.kse-jcu.org http://dx.doi.org/10.4250/jcu.2016.24.3.197