Case Control Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Pediatr. Jan 9, 2022; 11(1): 71-84
Published online Jan 9, 2022. doi: 10.5409/wjcp.v11.i1.71
Tissue Doppler, speckling tracking and four-dimensional echocardiographic assessment of right ventricular function in children with dilated cardiomyopathy
Mohammed Al-Biltagi, Osama Elrazaky, Wegdan Mawlana, Esraa Srour, Ahmed Hamdy Shabana
Mohammed Al-Biltagi, Osama Elrazaky, Wegdan Mawlana, Esraa Srour, Ahmed Hamdy Shabana, Department of Pediatrics, Faculty of Medicine, Tanta University, Tanta 31512, Algharbia, Egypt
Mohammed Al-Biltagi, Department of Pediatrics, University Medical Center, Arabian Gulf University, Manama 26671, Manama, Bahrain
Author contributions: Elrazaky O, Srour E, and Shabana AH did the echocardiographic studies and collected the data; Mawlana W and Al-Biltagi M analyzed the data and wrote the manuscript; all the authors revised and agreed to the final version of the manuscript.
Institutional review board statement: We performed the study according to the latest version of Helsinki's Declaration. The Institutional Ethical and Research Review Board of Faculty of Medicine, Tanta University, approved the study.
Informed consent statement: All parents, guardians, or next of kin signed informed consent for the minors to participate in this study.
Conflict-of-interest statement: The authors declare no conflict of interest for this article.
Data sharing statement: Data are available upon reasonable request.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Mohammed Al-Biltagi, MBChB, MD, MSc, PhD, Chairman, Professor, Department of Pediatrics, Faculty of Medicine, Tanta University, Al Bahr Street, Tanta 31512, Algharbia, Egypt. mbelrem@hotmail.com
Received: June 4, 2021
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
ARTICLE HIGHLIGHTS
Research background

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.

Research motivation

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.

Research objectives

The study aimed to evaluate right ventricular (RV) function in children with idiopathic DCM using relatively recent echocardiographic modalities.

Research methods

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.

Research results

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.

Research conclusions

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.

Research perspectives

We need to do a serial long-term echocardiographic study and relate worsening cardiac function to the possibility of complications.