Published online Jan 9, 2022. doi: 10.5409/wjcp.v11.i1.71
Peer-review started: June 4, 2021
First decision: October 17, 2021
Revised: October 21, 2021
Accepted: December 22, 2021
Article in press: December 22, 2021
Published online: January 9, 2022
Dilated cardiomyopathy (DCM) is a clinical condition associated with left ventricular (LV) or biventricular dilation with an impaired contraction. Clinical presentation of DCM mainly relates to the degree of LV or biventricular systolic dysfunction leading to pump failure.
To diagnose early cardiac dysfunction in dilated cardiomyopathy, we need to perform a cardiac examination using a tool with high sensitivity. M-mode, 2-dimensional echocardiography, tissue Doppler imaging (TDI), and Two-dimensional speckle tracking imaging are commonly used echocardiographic modalities to provide accurate and early detection of cardiac dysfunction.
The study aimed to evaluate right ventricular (RV) function in children with idiopathic DCM using relatively recent echocardiographic modalities.
The study was a prospective case-control study, including 50 children with idiopathic DCM and 50 healthy children as a control group, to study RV function using four-dimensional echocardiography (4-DE), TDI, and two-dimensional-speckles tracking echocardiography (2-D-STE). RV ejection fractions (EF) was measured by 4-DE.
The auto left (LV) EF measured by 2-D-STE were significantly lower in the patients’ group than in the control. The sphericity index was also significantly lower in children with DCM than in the control. RV EF measured by 4-DE was significantly lower in the patient's group than the control. RV S wave, e´/a´ ratio, myocardial performance index (MPI), and tricuspid annular plane systolic excursion (TAPSE) were significantly impaired in children with DCM than in control. Both LV and RV global longitudinal strains (GLS) were significantly reduced in children with DCM than in control. RVGLS was significantly associated with the duration since diagnosis, tricuspid annulus S wave, RV MPI, and TAPSE, but not with the age of the patients, RV EF, or e´/a´ ratio.
Impairment of the RV LGS and other systolic and diastolic parameters in children with DCM using STE and TDI can help detect RV function's early decline.
We need to do a serial long-term echocardiographic study and relate worsening cardiac function to the possibility of complications.