Echocardiographic assessment of left ventricular dyssynchrony in Egyptian children with congestive heart failure due to dilated cardiomyopathy.

OBJECTIVE

To evaluate the presence of cardiac dyssynchrony in Egyptian children with congestive heart failure due to dilated cardiomyopathy.

MATERIALS AND

METHODS

A total of 30 children with congestive cardiac failure due to dilated cardiomyopathy and 30 healthy age-matched controls were examined with conventional echocardiography, tissue Doppler, and speckle tracking imaging.

RESULTS

Conventional Doppler echocardiography demonstrated significant left ventricular systolic and diastolic dysfunction in the patient group. Tissue Doppler showed significant decrease in S-wave velocity and E'/A' ratio, and prolonged isovolumic contraction and relaxation times of mitral annulus as well as significant prolongation in mean difference between time-to-peak systolic strain of the basal septal and basal lateral segments in the patient group compared with the control group (p<0.005). Speckle tracking imaging demonstrated significant prolongation in mean difference between time-to-peak systolic strain of anteroseptal and posterior segments in both circumferential and radial strain analysis in the patient group than in the control group (p<0.005). It also demonstrated significant prolongation in the mean difference between time-to-peak systolic strain of the basal septal and basal lateral segments in longitudinal strain analysis in the patient group than in the control group (p<0.005). A significant increase in the standard deviation of time-to-peak strain, as a marker of increased intra-ventricular dyssynchrony, was present in the patient group compared with the control group (p=0.008).

CONCLUSION

Children with congestive heart failure due to dilated cardiomyopathy usually suffer from significant intra-ventricular dyssynchrony. Tissue Doppler imaging and speckle tracking imaging strain analysis are helpful tools to detect the presence of cardiac dyssynchrony.