Tissue Doppler, speckling tracking and four-dimensional echocardiographic assessment of right ventricular function in children with dilated cardiomyopathy

Table 1 Demographic and clinical data of children with during dilated cardiomyopathies and control group

Variables (mean ± SD)	Children with DCM (n = 50)	Controls (n = 50)	t	P value
Age	4.9 ± 2.3	5.56 ± 2.4	0.18	> 0.05
Sex
Male	32 (64.0%)	31 (62%)	ZS: 0.2	> 0.05
Female	18 (36.0%)	19 (38%)	ZS: 0.2	> 0.05
Consanguinity	23 (46%)	5 (10%)	-4	0.00011
Family history of DCM, n (%)	4 (8)	0
Weight	16.92 ± 5.95	20.60 ± 5.97	3	0.0021
Length (cm)	98 ± 4.8	105 ± 4.4	7.6	0.00011
BMI	17.6 ± 2.1	18.7 ± 2.5	2.4	0.021
Heart rate	105 ± 12	91 ± 7	7.1	0.00011
Systolic BP	86 ± 8	98 ± 7	8	0/00011
Diastolic BP	63 ± 4	68 ± 5	5.5	0.00011

¹Significant (P < 0.05).

BMI: Body mass index; BP: Blood pressure; ZS: Z-score; DCM: During dilated cardiomyopathy; SD: Standard deviation.

Table 2 Echocardiographic data of children with dilated cardiomyopathies and control group

Variables (mean ± SD)	Children with DCM (n = 50)	Controls (n = 50)	t	P value
LV echocardiographic parameters
Auto LV EF (speckle tracking)	43.4 ± 11.7	65.2 ± 7.6	11	0.00011
Sphericity index	1.2 ± 0.35	1.6 ± 0.3	6.2	0.00011
Presence of mitral regurgitation, n (%)	43 (86)	1 (2)	ZS: 6.6	0.00011
Mitral annulus systolic velocity (cm/sec)	3.7 ± 1.1	6.933 ± 0.785	16.9	0.00011
Mitral annulus e´/a´ ratio	1.15 ± 0.4	1.540 ± 0.246	5.8	0.00011
LV IVRT	75.0 ± 18.3	64.0 ± 7.2	4	0.00011
LV MPI	1.9± 0.3	0.4 ± 0.08	423	0.00011
LV GLS	-12.7 ± 4.9	-24.4 ± 1.6	16	0.00011
RV echocardiographic parameters
4D RV EF	32.2 ± 10.5	46.2 ± 10.7	8.7	0.00011
Tricuspid annulus S wave (cm/sec)	4.42 ± 0.82	6.9 ± 0.8	15	0.00011
Tricuspid annulus e´/a´ ratio	1.17 ± 0.25	1.52 ± 0.3	6.34	0.00011
RV MPI	0.86 ± 0.16	0.40 ± 0.08	18.2	0.00011
Mean pulmonary pressure (mmHg)	28.5 ± 6	21 ± 4	7.4	0.00011
TAPSE (mm)	12.00 ± 3.56	19.30 ± 2.5	12.5	0.00011
RV GLS	-10.34 ± 4.6	-24.30 ± 2.9	18.5	0.00011
RV apical strain	-13.3 ± 4.3	-26.70 ± 1.3	21	0.00011
RV mid strain	-12.4 ± 3.9	-23.20 ± 1.7	17.9	0.00011
RV basal strain	-13.7 ± 4.8	-25.30 ± 1.5	16.3	0.00011

¹Significant (P < 0.05).

EF: Ejection fraction; LVGLS: Left ventricular global longitudinal systolic strain; IVRT: Isovolumic relaxation time; LV: Left ventricle; MPI: Myocardial Performance Index; RV GLS: Right ventricular global longitudinal systolic strain; TAPSE: Tricuspid annular plane systolic excursion, RV: Right ventricle; ZS: Z-score.

Table 3 Multiple linear regression showing clinical and echocardiographic parameters that were independently associated with the longitudinal strain of the right ventricle among the studied children with dilated cardiomyopathy (n = 50)

Variables	RV LGS (%) among children with dilated cardiomyopathy (n = 50)
	β standardized coefficients	P value
Age (yr)	-0.274	0.057
Duration since diagnosis	0.578	0.0011
Weight (kg)	0.273	0.058
Tricuspid annulus (S) (cm/sec)	0.384	0.0081
RV e´/a´ ratio	0.277	0.059
RV MPI	-0.357	0.011
RV EF (%)	0.119	0.435
TAPSE (mm)	0.670	0.00011

¹Significant (P < 0.05).

RV EF: Right ventricular ejection fraction; LS: Longitudinal strain; MPI: Myocardial performance index; S: systolic velocity by tissue Doppler; TAPSE: Tricuspid annular plane systolic excursion.