Left ventricular vortex analysis by high-frame rate blood speckle tracking echocardiography in healthy children and in congenital heart disease. (December 2021)

• Record Type: Journal Article
• Authors: Marchese, Pietro; Cantinotti, Massimiliano; Van den Eynde, Jef; Assanta, Nadia; Franchi, Eliana; Pak, Vitali; Santoro, Giuseppe; Koestenberger, Martin; Kutty, Shelby
• Is Part Of: IJC heart & vasculature. Volume 37(2021)
• Publication Date: 2021-12
• Subjects: Blood speckle imaging -- Heart defects -- Congenital -- Echocardiography -- Left ventricle -- Pediatrics -- Vortex imaging; AV atrioventricular -- BMI body mass index -- Bpm beats per minute -- BSA body surface area -- BST blood speckle tracking -- CHD congenital heart disease -- CI correlation index -- ED end-diastolic -- Fps frame per second -- -i indexed to BSA -- ICC intraclass correlation coefficient -- IQR interquartile range -- IVS interventricular septum -- LV left ventricle/ventricular -- LVEDA left ventricular end-diastolic area -- LVEDD left ventricular end-diastolic dimension -- LVEDV left ventricular end-diastolic volume -- LVEF left ventricular ejection fraction -- LVESD left ventricular end-systolic dimension -- LVESV left ventricular end-systolic volume -- LVOT left ventricular outflow tract -- LVPO CHD involving left ventricle pressure overload -- LVSV left ventricular stroke volume -- LVVO CHD involving left ventricular volume overload -- MV mitral valve -- RVPO CHD involving right ventricular pressure overload -- RVVO CHD involving right ventricular volume overload -- TGA transposition of the great arteries; Cardiovascular system -- Diseases -- Periodicals; Cardiovascular system -- Pathophysiology -- Periodicals; 616.1005
• DOI: 10.1016/j.ijcha.2021.100897
• Languages: English
• ISSNs: 2352-9067

Abstract

Highlights: Utilization of high-frame rate blood speckle tracking echocardiography. Left ventricular (LV) vortices were analyzed in a pediatric population. No overall effect of congenital heart disease was observed. LV volume and pressure overload influenced vortex localization. Significant associations of LV morphology with vortex characteristics were found. Abstract: Background: High-frame rate blood speckle tracking (BST) echocardiography is a new technique for the assessment of intracardiac flow. The purpose of this study was to evaluate the characteristics of left ventricular (LV) vortices in healthy children and in those with congenital heart disease (CHD). Methods: Characteristics of LV vortices were analyses based on 4-chamber BST images from 118 healthy children (median age 6.84 years, range 0.01–17 years) and 43 children with CHD (median age 0.99 years, range 0.01–14 years). Both groups were compared after propensity matching. Multiple linear regression was used to identify factors that independently influence vortex characteristics. Results: Feasibility of vortex imaging was 93.7% for healthy children and 95.6% for CHD. After propensity matching, there were no overall significant differences in vortex distance to apex, distance to interventricular septum (IVS), height, width, sphericity index, or area. However, multiple regression analysis revealed significant associations of LV morphology with vortex characteristics. Furthermore, CHD involving LV volume overload and CHD involving LV pressure overload were both associated with vortices localized closer to the IVS. Conclusions: LV vortex analysis using high-frame rate BST echocardiography is feasible in healthy children and in those with CHD. As they are associated with LV morphology and are modified in some types of CHD, vortices might yield diagnostic and prognostic value. Future studies are warranted to establish applications of vortex imaging in the clinical setting.