Abstract
Speckle tracking echocardiography (STE) is increasingly used during functional assessments. However, reproducibility and dependence on echocardiographic image quality for speckle tracking stress echocardiography in pediatric patients have not been studied to date. 127 consecutive normotensive children without structural heart disease (mean age 13.4 ± 3.0 years, 50.4% female) underwent a stepwise semisupine cycle ergometric protocol. Left ventricular (LV) myocardial peak strain and strain rate were assessed at rest and during exercise. Interobserver and intraobserver assessments were performed and analyzed regarding echocardiographic image quality. LV peak global strain and strain rate were well reproducible with narrow limits of agreement without any significant bias both at rest and during all stages of exercise testing. Moreover, strain rate reproducibility slightly deteriorated in values between −1.5 and −3 s−1. Surprisingly, there was no significant difference in reproducibility between optimal, intermediate and poor quality of echocardiographic images. STE derived strain and strain rate measurements in children are feasible and highly reproducible during semisupine cycle ergometric stress echocardiography. Echocardiographic image quality does not seem to influence strain (rate) reproducibility. Myocardial deformation measurements in images with suboptimal visualization quality must be interpreted with caution.
Highlights
Speckle tracking echocardiography (STE) is increasingly used during functional assessments
Patient characteristics. 127 children were included in this prospective study
All included study subjects had no signs of structural heart disease, and their anthropometric data was in accordance with their age and maturation level as evaluated by Z-scores
Summary
Speckle tracking echocardiography (STE) is increasingly used during functional assessments. In a pursuit to increase the diagnostic yield of functional cardiac imaging, STE is increasingly used in combination with dobutamine or ergometer stress testing[7]. The mainstay of this combination in adult medicine is non-invasive workup for coronary artery disease[8]. Reproducibility and the significance of image quality during pediatric bicycle ergometer stress testing are still poorly studied This is the first study to assess the relation of echocardiographic image quality and inter- and intraobserver reproducibility of STE in combination with stress echocardiography in children
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