Three-Dimensional Speckle Tracking Echocardiography for the Assessment of Cardiac Function in Newborns with Extra- Cardiac Diseases

Abstract

Neonatal heart could be affected by extracardiac diseases as neonatal sepsis, neonatal pneumonia, hypoxic-ischemic encephalopathy. Cardiac function in neonates can’t be accurately assessed using conventional methods. Advanced echocardiographic parameters can be used to evaluate neonatal cardiac function as Tissue Doppler Imaging (TDI) and speckle tracking echocardiography. This study aimed at assessing the role of three-dimensional speckle tracking echocardiography (3D-STE) in detection of subclinical myocardial dysfunction in newborns with common extra-cardiac neonatal diseases. In this work; 100 asymptomatic cardiac newborns with extra-cardiac neonatal diseases were included as a patient group. Fifty healthy newborns of matched age, sex, and weight served as a control group. Laboratory investigations in the form of complete blood count (CBC), liver function test, renal function test, capillary blood gas, serum electrolytes, cardiac troponin I (cTnT-I) and N-terminal Pro-BNP were drawn. Complete echocardiographic evaluation of the left ventricular (LV) function was performed in the form of conventional echo, tissue Doppler imaging (TDI), 2-dimensional speckle tracking echocardiography (2D-STE) and 3-dimensional speckle tracking echocardiography (3D-STE). cTnT-I and N-terminal Pro-BNP levels were significantly higher in the patient group than the control group. Conventional echocardiography showed normal systolic and diastolic function of the LV. Diastolic function (by TDI) was significantly lower in the patient group than control group. 2D-STE and 3D-STE examination showed that there was a significant decrease in all components of strain in the patient group compared to the control group. In conclusion; 3D-STE is a good tool for prediction of silent cardiac dysfunction in newborns with extracardiac neonatal diseases