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ASSESSMENT OF LEFT VENTRICULAR STRAIN AND ITS CLINICAL CORRELATIONS IN ISOLATED LEFT VENTRICULAR NON-COMPACTION
2094 JACC March 21, 2017 Volume 69, Issue 11
ACC International Conferences Best Posters ASSESSMENT OF LEFT VENTRICULAR STRAIN AND ITS CLINICAL CORRELATIONS IN ISOLATED LEFT VENTRICULAR NON-COMPACTION Poster Contributions Poster Hall, Hall C Friday, March 17, 2017, 10:00 a.m.-10:45 a.m. Session Title: ACC International Conferences Best Posters Abstract Category: 10. Congenital Heart Disease: Pediatric Presentation Number: 1050-456 Authors: Putri Yubbu, Andrea Montero, Hythem Nawaytou, Anirban Banerjee, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
Introduction: Myocardial deformation demonstrates regional systolic dysfunction even with preserved ejection fraction (EF). We studied left ventricular (LV) global and regional strain patterns and clinical characteristic of isolated LV non-compaction (LVNC) in pediatric patients. Methods: We prospectively studied 30 patients with LVNC (47% Male; median age 5.7 years, range 0.8-18 years) and 30 controls. Longitudinal(LS), circumferential(CS) and radial strains (RS)were assessed by speckle tracking echocardiography (STE).The degree of non-compaction in each segment was graded and strain patterns were evaluated from16-segment model of LV.
Results: A quarter of patients presented after 5 years of age with symptoms of heart murmur, arrhythmia or syncope. 23% of cases were diagnosed from screening of individual with positive family history. Most severely affected segment was apical lateral (81.5%). Mid inferior and mid posterior segments were also affected significantly, but to a lesser extent. About half of patients showed basal segment involvement. LS showed a strong correlation with NYHA class (r=0.72, p=0.0001).Compared to controls, global LS was significantly low (-20.82+ 1.99 vs -17.52 +4.72 p=0.0008). CS at basal segments was significantly low in symptomatic patients compared with patients in NYHA class I (-14.39±4.80 vs. -19.33±6.4, p=0.009). CS at basal (-24.55+1.68 vs. -19.07+4.83, p =0.0001), mid (-21.98 +3.73 vs -16.23+4.23, p=0.0001) and apical regions (-30.25 + 6.12 vs -19.21+ 5.4, p=0.0001) was decreased. LVEF correlated strongly with LS (r = -0.71, p<0.0001) and showed moderate correlation with CS (r = -0.43, p=0.02) but not with RS (r = 0.2, p = 0.27).Also strain pattern and clinical presentation correlated significantly with extension of non-compaction to mid- and basal- regions of LV. Conclusions: LS and CS provides reliable information regarding regional myocardial function. It is important to determine extension of LVNC to basal and mid septal regions, as it showed strong correlation with LV dysfunction.
ACC International Conferences Best Posters ASSESSMENT OF LEFT VENTRICULAR STRAIN AND ITS CLINICAL CORRELATIONS IN ISOLATED LEFT VENTRICULAR NON-COMPACTION Poster Contributions Poster Hall, Hall C Friday, March 17, 2017, 10:00 a.m.-10:45 a.m. Session Title: ACC International Conferences Best Posters Abstract Category: 10. Congenital Heart Disease: Pediatric Presentation Number: 1050-456 Authors: Putri Yubbu, Andrea Montero, Hythem Nawaytou, Anirban Banerjee, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
Introduction: Myocardial deformation demonstrates regional systolic dysfunction even with preserved ejection fraction (EF). We studied left ventricular (LV) global and regional strain patterns and clinical characteristic of isolated LV non-compaction (LVNC) in pediatric patients. Methods: We prospectively studied 30 patients with LVNC (47% Male; median age 5.7 years, range 0.8-18 years) and 30 controls. Longitudinal(LS), circumferential(CS) and radial strains (RS)were assessed by speckle tracking echocardiography (STE).The degree of non-compaction in each segment was graded and strain patterns were evaluated from16-segment model of LV.
Results: A quarter of patients presented after 5 years of age with symptoms of heart murmur, arrhythmia or syncope. 23% of cases were diagnosed from screening of individual with positive family history. Most severely affected segment was apical lateral (81.5%). Mid inferior and mid posterior segments were also affected significantly, but to a lesser extent. About half of patients showed basal segment involvement. LS showed a strong correlation with NYHA class (r=0.72, p=0.0001).Compared to controls, global LS was significantly low (-20.82+ 1.99 vs -17.52 +4.72 p=0.0008). CS at basal segments was significantly low in symptomatic patients compared with patients in NYHA class I (-14.39±4.80 vs. -19.33±6.4, p=0.009). CS at basal (-24.55+1.68 vs. -19.07+4.83, p =0.0001), mid (-21.98 +3.73 vs -16.23+4.23, p=0.0001) and apical regions (-30.25 + 6.12 vs -19.21+ 5.4, p=0.0001) was decreased. LVEF correlated strongly with LS (r = -0.71, p<0.0001) and showed moderate correlation with CS (r = -0.43, p=0.02) but not with RS (r = 0.2, p = 0.27).Also strain pattern and clinical presentation correlated significantly with extension of non-compaction to mid- and basal- regions of LV. Conclusions: LS and CS provides reliable information regarding regional myocardial function. It is important to determine extension of LVNC to basal and mid septal regions, as it showed strong correlation with LV dysfunction.