Maturational and Growth-Related Changes in Left Ventricular Longitudinal Strain and Strain Rate Measured by Two-Dimensional Speckle Tracking Echocardiography in Healthy Pediatric Population

Objective We aimed to evaluate myocardial strain and strain rate (SR) by novel 2-dimensional speckle tracking echocardiography in a large pediatric cohort (1) to establish their normal values and (2) to discern the influence of maturation and cardiac growth on them. Methods Echocardiograms of 284 consecutive subjects of a healthy pediatric cohort aged between birth and 18 years were analyzed by vector velocity imaging software to measure longitudinal systolic strain (ε) and systolic and diastolic SR in left ventricular septal and lateral segments. Regression analysis was performed to determine the effect of aging and cardiac growth on ε and SR. Results Longitudinal ε (septal −18.30% ± 6.67% and lateral −20.68% ± 8.08%) did not change significantly with maturation and declining heart rate from birth to 18 years. Systolic and early diastolic SR declined until age 5 to 10 years. Longitudinal ε significantly ( P < .05) correlated with left ventricular growth. Conclusion This study establishes reference values for longitudinal ε and SR and reveals that ε is relatively independent of maturational changes, lending it as a tool for cardiac evaluation across differing ages in pediatric subjects.