Two-dimensional speckle tracking of the ascending aorta: a novel approach to evaluate arterial stiffness in pediatric patients with repaired conotruncal anomalies using echocardiography
BackgroundChildren with repaired conotruncal abnormalities (CTA) are at risk of progressive aortic dilation and deteriorating aortic elasticity even after surgical correction. Strain imaging, using a 2-dimensional speckle tracking echocardiography (2D-STE), has been used for arterial stiffness asses...
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Frontiers Media S.A.
2025-03-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2025.1555568/full |
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| author | Anmol Goyal Anmol Goyal Anitha Parthiban David A. White David A. White Daniel Forsha Daniel Forsha Doaa Aly |
| author_facet | Anmol Goyal Anmol Goyal Anitha Parthiban David A. White David A. White Daniel Forsha Daniel Forsha Doaa Aly |
| author_sort | Anmol Goyal |
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| description | BackgroundChildren with repaired conotruncal abnormalities (CTA) are at risk of progressive aortic dilation and deteriorating aortic elasticity even after surgical correction. Strain imaging, using a 2-dimensional speckle tracking echocardiography (2D-STE), has been used for arterial stiffness assessment, but pediatric data are still lacking. We investigated the feasibility, reproducibility, and clinical value of 2D-STE derived ascending aorta (AAo) stiffness in children with repaired CTA.Methods22 pediatric patients with repaired CTA were included along with 25 age- and sex- matched healthy controls (mean age 10.2 ± 4.5 years). Conventional 2D echocardiographic and 2D-STE assessment of AAo mechanics was performed. M-mode AAo strain, aortic distensibility and aortic stiffness index as well as 2D-STE derived AAo global circumferential strain (GCS) were calculated and compared between groups.Results2D-STE was successfully performed and analyzed in the entire, prospectively enrolled cohort. Patients with repaired CTA had significantly lower 2D-STE derived AAo GCS compared to controls (9.4 ± 1.3 vs. 15.2 ± 1.7, P-value <0.001). AAo GCS in repaired CTA patients had strong negative correlation with age (r = −0.76, CI −0.9 to −0.51) and a moderate negative correlation with the absolute aortic valve annulus (r = −0.55), absolute aortic root (r = −0.67), absolute sino-tubular junction (r = −0.67) and absolute AAo dimension (r = −0.71). On multivariate analysis, absolute aortic root and ascending aorta dimension were significantly associated with AAo GCS independent of other variables. Intra-observer reproducibility was good to excellent for the CTA and entire cohort (ICC = 0.87 and 0.96 respectively), while inter-observer reproducibility was moderate for the CTA cohort 0.71 vs. 0.92 for the entire cohort.ConclusionAAo GCS using 2D STE is highly feasible and reproducible as well as provides novel insights into the aortic deformation mechanics in pediatric patients with repaired CTA, thus holds promise in longitudinal assessment and risk stratification of aortopathy-associated congenital heart disease patients. |
| format | Article |
| id | doaj-art-7bc2fda3329547cb834914be55e429d0 |
| institution | Kabale University |
| issn | 2297-055X |
| language | English |
| publishDate | 2025-03-01 |
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| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj-art-7bc2fda3329547cb834914be55e429d02025-08-20T03:42:56ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2025-03-011210.3389/fcvm.2025.15555681555568Two-dimensional speckle tracking of the ascending aorta: a novel approach to evaluate arterial stiffness in pediatric patients with repaired conotruncal anomalies using echocardiographyAnmol Goyal0Anmol Goyal1Anitha Parthiban2David A. White3David A. White4Daniel Forsha5Daniel Forsha6Doaa Aly7Ward Family Heart Center, Children’s Mercy Hospital, Kansas City, MO, United StatesDepartment of Pediatrics, University of Missouri-Kansas City School of Medicine, Kansas City, MO, United StatesDepartment of Pediatric Cardiology, Texas Children’s Hospital, Baylor College of Medicine Houston, Houston, TX, United StatesWard Family Heart Center, Children’s Mercy Hospital, Kansas City, MO, United StatesDepartment of Pediatrics, University of Missouri-Kansas City School of Medicine, Kansas City, MO, United StatesWard Family Heart Center, Children’s Mercy Hospital, Kansas City, MO, United StatesDepartment of Pediatrics, University of Missouri-Kansas City School of Medicine, Kansas City, MO, United StatesBenioff Children’s Hospital, University of California San Francisco, San Francisco, CA, United StatesBackgroundChildren with repaired conotruncal abnormalities (CTA) are at risk of progressive aortic dilation and deteriorating aortic elasticity even after surgical correction. Strain imaging, using a 2-dimensional speckle tracking echocardiography (2D-STE), has been used for arterial stiffness assessment, but pediatric data are still lacking. We investigated the feasibility, reproducibility, and clinical value of 2D-STE derived ascending aorta (AAo) stiffness in children with repaired CTA.Methods22 pediatric patients with repaired CTA were included along with 25 age- and sex- matched healthy controls (mean age 10.2 ± 4.5 years). Conventional 2D echocardiographic and 2D-STE assessment of AAo mechanics was performed. M-mode AAo strain, aortic distensibility and aortic stiffness index as well as 2D-STE derived AAo global circumferential strain (GCS) were calculated and compared between groups.Results2D-STE was successfully performed and analyzed in the entire, prospectively enrolled cohort. Patients with repaired CTA had significantly lower 2D-STE derived AAo GCS compared to controls (9.4 ± 1.3 vs. 15.2 ± 1.7, P-value <0.001). AAo GCS in repaired CTA patients had strong negative correlation with age (r = −0.76, CI −0.9 to −0.51) and a moderate negative correlation with the absolute aortic valve annulus (r = −0.55), absolute aortic root (r = −0.67), absolute sino-tubular junction (r = −0.67) and absolute AAo dimension (r = −0.71). On multivariate analysis, absolute aortic root and ascending aorta dimension were significantly associated with AAo GCS independent of other variables. Intra-observer reproducibility was good to excellent for the CTA and entire cohort (ICC = 0.87 and 0.96 respectively), while inter-observer reproducibility was moderate for the CTA cohort 0.71 vs. 0.92 for the entire cohort.ConclusionAAo GCS using 2D STE is highly feasible and reproducible as well as provides novel insights into the aortic deformation mechanics in pediatric patients with repaired CTA, thus holds promise in longitudinal assessment and risk stratification of aortopathy-associated congenital heart disease patients.https://www.frontiersin.org/articles/10.3389/fcvm.2025.1555568/fullspeckle tracking echocardiographyarterial stiffnessaortic strainconotruncal abnormalitiespediatrics |
| spellingShingle | Anmol Goyal Anmol Goyal Anitha Parthiban David A. White David A. White Daniel Forsha Daniel Forsha Doaa Aly Two-dimensional speckle tracking of the ascending aorta: a novel approach to evaluate arterial stiffness in pediatric patients with repaired conotruncal anomalies using echocardiography Frontiers in Cardiovascular Medicine speckle tracking echocardiography arterial stiffness aortic strain conotruncal abnormalities pediatrics |
| title | Two-dimensional speckle tracking of the ascending aorta: a novel approach to evaluate arterial stiffness in pediatric patients with repaired conotruncal anomalies using echocardiography |
| title_full | Two-dimensional speckle tracking of the ascending aorta: a novel approach to evaluate arterial stiffness in pediatric patients with repaired conotruncal anomalies using echocardiography |
| title_fullStr | Two-dimensional speckle tracking of the ascending aorta: a novel approach to evaluate arterial stiffness in pediatric patients with repaired conotruncal anomalies using echocardiography |
| title_full_unstemmed | Two-dimensional speckle tracking of the ascending aorta: a novel approach to evaluate arterial stiffness in pediatric patients with repaired conotruncal anomalies using echocardiography |
| title_short | Two-dimensional speckle tracking of the ascending aorta: a novel approach to evaluate arterial stiffness in pediatric patients with repaired conotruncal anomalies using echocardiography |
| title_sort | two dimensional speckle tracking of the ascending aorta a novel approach to evaluate arterial stiffness in pediatric patients with repaired conotruncal anomalies using echocardiography |
| topic | speckle tracking echocardiography arterial stiffness aortic strain conotruncal abnormalities pediatrics |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2025.1555568/full |
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