Ari Mehmet Emre, Cetin Ibrahim Ilker, Kocabas Abdullah, Ekici Filiz, Ceylan Ozben, Surucu Murat
Department of Pediatric Cardiology, Ankara Children's Hematology and Oncology Research and Training Hospital, Ziraat Mah. Irfan Bastug Cad. Kurtdereli Sok. No: 10 Dışkapı/Altındag, Ankara, Turkey.
Department of Pediatric Cardiology, Dr. Sami Ulus Obstetrics and Gynecology, Children's Health and Diseases Training and Research Hospital, Ankara, Turkey.
Pediatr Cardiol. 2016 Jan;37(1):201-7. doi: 10.1007/s00246-015-1266-6. Epub 2015 Sep 22.
Echocardiography is the mainstay of screening and disease surveillance in isolated left ventricular non-compaction (iLVNC). The aim of our study is to determine the early regional and global myocardial functional changes and whether the myocardial changes that cannot be detected by conventional echocardiography could be detected by tissue Doppler imaging (TDI) or two-dimensional speckle-tracking echocardiography (STE) in iLVNC cases without symptoms. Longitudinal and circumferential strain (S) and strain rates (SR) as determined by STE in 20 children aged 12.1 ± 3.3 years was compared with those in 20 controls. All children underwent echocardiographic assessment using two-dimensional, tissue Doppler and speckle-tracking echocardiography. iLVNC patients who had normal systolic function by ejection and shortening fractions were included in this study. According to the TDI in all three segments [the non-compacted (NC), neighboring NC (NNC) and compacted (C) segments], isovolumic contraction time, isovolumic relaxation time and myocardial performance index values were significantly higher, while ejection time were significantly lower in the iLVNC group. According to STE in two segments (NC and NNC-segments) longitudinal S and SR values and also circumferential S and SR values were significantly lower in the iLVNC group compared with the control group; whereas, in the global measurements both longitudinal and circumferential S and SR values in all three segments were significantly lower in the iLVNC group compared with the control group. We believe that TDI and STE that evaluates myocardial deformation can be used for the detection of early myocardial dysfunction in the iLVNC patients who are subclinical and whose left ventricular functions were detected as normal by conventional methods with normal ejection and shortening fractions.
超声心动图是孤立性左心室心肌致密化不全（iLVNC）筛查和疾病监测的主要手段。我们研究的目的是确定早期局部和整体心肌功能变化，以及在无症状的iLVNC病例中，组织多普勒成像（TDI）或二维斑点追踪超声心动图（STE）能否检测到常规超声心动图无法检测到的心肌变化。将20名年龄为12.1±3.3岁儿童通过STE测定的纵向和圆周应变（S）及应变率（SR）与20名对照组儿童进行比较。所有儿童均接受二维、组织多普勒和斑点追踪超声心动图的超声心动图评估。本研究纳入射血分数和缩短分数正常的收缩功能正常的iLVNC患者。根据所有三个节段[非致密化（NC）、相邻非致密化（NNC）和致密化（C）节段]的TDI，iLVNC组等容收缩时间、等容舒张时间和心肌性能指数值显著更高，而射血时间显著更低。根据STE在两个节段（NC和NNC节段），iLVNC组纵向S和SR值以及圆周S和SR值均显著低于对照组；而在整体测量中，iLVNC组所有三个节段的纵向和圆周S及SR值均显著低于对照组。我们认为，评估心肌变形的TDI和STE可用于检测亚临床iLVNC患者的早期心肌功能障碍，这些患者通过常规方法检测左心室功能正常，射血分数和缩短分数正常。
