Alterations in Left Ventricular Circumferential Motion in Children with Dilated Cardiomyopathy

ABSTRACT

PURPOSE: The purpose of this study is to analyze left ventricular (LV) circumferential strain (S) and strain rate (SR) in children with dilated cardiomyopathy (DCM) and to evaluate whether the impairment of circumferential wall motion correlates with global ventricular dysfunction in DCM. METHODS: Ten DCM children (range 0.6-15 years, median 6.5 years, 3 females) and 17 age and sex matched normal controls were examined. After conventional echocardiography and tissue Doppler imaging analysis, segmental and global circumferential S and SR were measured using two dimensional speckle tracking imaging (STI) method at three levels of LV. RESULTS: Circumferential S and SR were markedly heterogeneous and decreased in almost all segments of LV in DCM. Peak global Sc (Sc G) was significantly reduced at three levels of LV (basal level; -15.7+/-3.8% vs. -9.5+/-3.6%, P=0.001, midventricular level; -13.5+/-3.5% vs. -6.5+/-3.3%, P<0.001, apical level; 14+/-5.1% vs. 6.2+/-4.1%, P=0.005). Global circumferential S and SR were correlated closely with other indices of global LV function and longitudinal and radial motion in normal and DCM children. CONCLUSION: In DCM, decreased circumferential S and SR are the major components of LV dysfunction. Analysis of circumferential S and SR with STI method can give further information on 3 dimensional LV mechanics in DCM.