Distribution of strain patterns in children with dilated cardiomyopathy

Susanna L. den Boer, Gideon J. du Marchie Sarvaas, Liselotte M. Klitsie, Gabriëlle G. van Iperen, Ronald B. Tanke, Willem A. Helbing, Ad P.C.M. Backx, Lukas A.J. Rammeloo, Michiel Dalinghaus, Arend D.J. ten Harkel

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Objectives: This study aimed to evaluate the predicting value of quantitative and qualitative dyssynchrony parameters as assessed by two-dimensional speckle tracking echocardiography (STE) on outcome in children with dilated cardiomyopathy (DCM). Furthermore, the reproducibility of these parameters was investigated. Background: In previous studies in adults with heart failure, several dyssynchrony parameters have been shown to be a valuable predictor of clinical outcome. Methods: This multicenter, prospective study included 75 children with DCM and 75 healthy age-matched controls. Using STE, quantitative (time to global peak strain and parameters describing intraventricular time differences) and qualitative dyssynchrony parameters (pattern analysis) of the apical four-chamber, three-chamber, two-chamber views, and the short axis of the left ventricle were assessed. Cox regression was used to identify risk factors for the primary endpoints of death or heart transplantation. Inter-observer and intra-observer variability were described. Results: During a median of 21 months follow-up, 10 patients (13%) reached an endpoint. Although quantitative dyssynchrony measures were higher in patients as compared to controls, the inter-observer and intra-observer variability were high. Pattern analysis showed mainly reduced strain, instead of dyssynchronous patterns. Conclusions: In this study, quantitative dyssynchrony parameters were not reproducible, precluding their use in children. Qualitative pattern analysis showed predominantly reduced strain, suggesting that in children with DCM dyssynchrony may be a minor problem.

Original languageEnglish
Pages (from-to)881-887
Number of pages7
JournalEchocardiography
Volume34
Issue number6
DOIs
Publication statusPublished - 1 Jun 2017

Cite this

den Boer, S. L., du Marchie Sarvaas, G. J., Klitsie, L. M., van Iperen, G. G., Tanke, R. B., Helbing, W. A., ... ten Harkel, A. D. J. (2017). Distribution of strain patterns in children with dilated cardiomyopathy. Echocardiography, 34(6), 881-887. https://doi.org/10.1111/echo.13548
den Boer, Susanna L. ; du Marchie Sarvaas, Gideon J. ; Klitsie, Liselotte M. ; van Iperen, Gabriëlle G. ; Tanke, Ronald B. ; Helbing, Willem A. ; Backx, Ad P.C.M. ; Rammeloo, Lukas A.J. ; Dalinghaus, Michiel ; ten Harkel, Arend D.J. / Distribution of strain patterns in children with dilated cardiomyopathy. In: Echocardiography. 2017 ; Vol. 34, No. 6. pp. 881-887.
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title = "Distribution of strain patterns in children with dilated cardiomyopathy",
abstract = "Objectives: This study aimed to evaluate the predicting value of quantitative and qualitative dyssynchrony parameters as assessed by two-dimensional speckle tracking echocardiography (STE) on outcome in children with dilated cardiomyopathy (DCM). Furthermore, the reproducibility of these parameters was investigated. Background: In previous studies in adults with heart failure, several dyssynchrony parameters have been shown to be a valuable predictor of clinical outcome. Methods: This multicenter, prospective study included 75 children with DCM and 75 healthy age-matched controls. Using STE, quantitative (time to global peak strain and parameters describing intraventricular time differences) and qualitative dyssynchrony parameters (pattern analysis) of the apical four-chamber, three-chamber, two-chamber views, and the short axis of the left ventricle were assessed. Cox regression was used to identify risk factors for the primary endpoints of death or heart transplantation. Inter-observer and intra-observer variability were described. Results: During a median of 21 months follow-up, 10 patients (13{\%}) reached an endpoint. Although quantitative dyssynchrony measures were higher in patients as compared to controls, the inter-observer and intra-observer variability were high. Pattern analysis showed mainly reduced strain, instead of dyssynchronous patterns. Conclusions: In this study, quantitative dyssynchrony parameters were not reproducible, precluding their use in children. Qualitative pattern analysis showed predominantly reduced strain, suggesting that in children with DCM dyssynchrony may be a minor problem.",
keywords = "dilated cardiomyopathy, myocardial strain",
author = "{den Boer}, {Susanna L.} and {du Marchie Sarvaas}, {Gideon J.} and Klitsie, {Liselotte M.} and {van Iperen}, {Gabri{\"e}lle G.} and Tanke, {Ronald B.} and Helbing, {Willem A.} and Backx, {Ad P.C.M.} and Rammeloo, {Lukas A.J.} and Michiel Dalinghaus and {ten Harkel}, {Arend D.J.}",
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den Boer, SL, du Marchie Sarvaas, GJ, Klitsie, LM, van Iperen, GG, Tanke, RB, Helbing, WA, Backx, APCM, Rammeloo, LAJ, Dalinghaus, M & ten Harkel, ADJ 2017, 'Distribution of strain patterns in children with dilated cardiomyopathy' Echocardiography, vol. 34, no. 6, pp. 881-887. https://doi.org/10.1111/echo.13548

Distribution of strain patterns in children with dilated cardiomyopathy. / den Boer, Susanna L.; du Marchie Sarvaas, Gideon J.; Klitsie, Liselotte M.; van Iperen, Gabriëlle G.; Tanke, Ronald B.; Helbing, Willem A.; Backx, Ad P.C.M.; Rammeloo, Lukas A.J.; Dalinghaus, Michiel; ten Harkel, Arend D.J.

In: Echocardiography, Vol. 34, No. 6, 01.06.2017, p. 881-887.

Research output: Contribution to journalArticleAcademicpeer-review

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T1 - Distribution of strain patterns in children with dilated cardiomyopathy

AU - den Boer, Susanna L.

AU - du Marchie Sarvaas, Gideon J.

AU - Klitsie, Liselotte M.

AU - van Iperen, Gabriëlle G.

AU - Tanke, Ronald B.

AU - Helbing, Willem A.

AU - Backx, Ad P.C.M.

AU - Rammeloo, Lukas A.J.

AU - Dalinghaus, Michiel

AU - ten Harkel, Arend D.J.

PY - 2017/6/1

Y1 - 2017/6/1

N2 - Objectives: This study aimed to evaluate the predicting value of quantitative and qualitative dyssynchrony parameters as assessed by two-dimensional speckle tracking echocardiography (STE) on outcome in children with dilated cardiomyopathy (DCM). Furthermore, the reproducibility of these parameters was investigated. Background: In previous studies in adults with heart failure, several dyssynchrony parameters have been shown to be a valuable predictor of clinical outcome. Methods: This multicenter, prospective study included 75 children with DCM and 75 healthy age-matched controls. Using STE, quantitative (time to global peak strain and parameters describing intraventricular time differences) and qualitative dyssynchrony parameters (pattern analysis) of the apical four-chamber, three-chamber, two-chamber views, and the short axis of the left ventricle were assessed. Cox regression was used to identify risk factors for the primary endpoints of death or heart transplantation. Inter-observer and intra-observer variability were described. Results: During a median of 21 months follow-up, 10 patients (13%) reached an endpoint. Although quantitative dyssynchrony measures were higher in patients as compared to controls, the inter-observer and intra-observer variability were high. Pattern analysis showed mainly reduced strain, instead of dyssynchronous patterns. Conclusions: In this study, quantitative dyssynchrony parameters were not reproducible, precluding their use in children. Qualitative pattern analysis showed predominantly reduced strain, suggesting that in children with DCM dyssynchrony may be a minor problem.

AB - Objectives: This study aimed to evaluate the predicting value of quantitative and qualitative dyssynchrony parameters as assessed by two-dimensional speckle tracking echocardiography (STE) on outcome in children with dilated cardiomyopathy (DCM). Furthermore, the reproducibility of these parameters was investigated. Background: In previous studies in adults with heart failure, several dyssynchrony parameters have been shown to be a valuable predictor of clinical outcome. Methods: This multicenter, prospective study included 75 children with DCM and 75 healthy age-matched controls. Using STE, quantitative (time to global peak strain and parameters describing intraventricular time differences) and qualitative dyssynchrony parameters (pattern analysis) of the apical four-chamber, three-chamber, two-chamber views, and the short axis of the left ventricle were assessed. Cox regression was used to identify risk factors for the primary endpoints of death or heart transplantation. Inter-observer and intra-observer variability were described. Results: During a median of 21 months follow-up, 10 patients (13%) reached an endpoint. Although quantitative dyssynchrony measures were higher in patients as compared to controls, the inter-observer and intra-observer variability were high. Pattern analysis showed mainly reduced strain, instead of dyssynchronous patterns. Conclusions: In this study, quantitative dyssynchrony parameters were not reproducible, precluding their use in children. Qualitative pattern analysis showed predominantly reduced strain, suggesting that in children with DCM dyssynchrony may be a minor problem.

KW - dilated cardiomyopathy

KW - myocardial strain

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den Boer SL, du Marchie Sarvaas GJ, Klitsie LM, van Iperen GG, Tanke RB, Helbing WA et al. Distribution of strain patterns in children with dilated cardiomyopathy. Echocardiography. 2017 Jun 1;34(6):881-887. https://doi.org/10.1111/echo.13548