ESPN 50th Annual Meeting

ESPN 2017


 
MYOCARDIAL DEFORMATION MEASURED BY 3D SPECKLE TRACKING IN CHILDREN AND ADOLESCENTS WITH PRIMARY SYSTEMIC ARTERIAL HYPERTENSION
SUSANNE NAVARINI 1 HANNAH BELLSHAM-REVELL 1 HENRY CHUBB 1 HAOTIAN GU.. 1 MANISH SINHA 1 JOHN SIMPSON 1

1- EVELINA LONDON CHILDRENS HOSPITAL
 
Introduction:

Systemic arterial hypertension predisposes children to cardiovascular risk in childhood and adult life. Despite extensive study of left ventricular hypertrophy, detailed 3D strain analysis of cardiac function in hypertensive children has not been reported. The aim of this study was to evaluate left ventricular mechanics (strain, twist and torsion) in young patients with hypertension compared to a healthy control group and assess factors associated with functional measurements.

Material and methods:

Patients aged less than 18 years with a diagnosis of primary arterial hypertension were included in the hypertension group and compared to healthy children. Standard 2D measurements were made using M-mode as well as 3D assessment of ventricular volumes and deformation, using speckle tracking echocardiography.

Results:

63 patients (26 hypertension and 37 healthy controls) were enrolled (mean age 14.3 years and 11.4 years, 54% male and 41% male respectively). There was no difference in left ventricular volumes and ejection fraction between the groups. Myocardial deformation was significantly reduced in those with hypertension compared to controls. For hypertension and controls respectively global longitudinal strain was -15.1 ± 2.3 vs -18.5 ± 1.9 (p<0.0001), global circumferential strain -15.2 ±3 vs -19.9 ± 3.1 (<0.0001), global radial strain +44.0 ± 11.3 vs 63.4 ± 10.5 (p<0.0001) and global 3D strain -26.1 ± 3.8 vs -31.5 ± 3.8 (p<0.0001). Basal clockwise rotation, apical counterclockwise rotation, twist and torsion were not significantly different. Following multivariate regression analyses blood pressure, body mass index and left ventricular mass maintained a significant relationship with measures of left ventricular strain.

Conclusions:

Despite maintaining a normal ejection fraction, children with hypertension had significantly lower global longitudinal, circumferential, radial and 3D strain than healthy children. Whether reduced strain might predict future cardiovascular risk merits further longitudinal study.