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Open Access 01-12-2015 | Review

Normal ranges of left ventricular strain in children: a meta-analysis

Authors: Haki Jashari, Annika Rydberg, Pranvera Ibrahimi, Gani Bajraktari, Lindita Kryeziu, Fisnik Jashari, Michael Y. Henein

Published in: Cardiovascular Ultrasound | Issue 1/2015

Abstract

Aims

The definition of normal values of two-dimensional speckle-tracking echocardiography derived left ventricular (LV) deformation parameters, is of critical importance for the routine application of this modality in children. The objectives of this study were to perform a meta-analysis of normal ranges for longitudinal, circumferential and radial strain/strain rate values and to identify confounders that may contribute to differences in reported measures.

Methods and Results

A systematic search was conducted. Studies describing normal healthy subjects and observational studies that used control groups as a comparison were included. Data were combined using a random-effect model. Effects of demographic, clinical and equipment variables were assessed through meta-regression. The search identified 1,192 subjects form 28 articles. Longitudinal strain (LS) normal mean values varied from -12.9 to -26.5 (mean, -20.5; 95% CI, -20.0 to -21.0). Normal mean values of circumferential strain (CS) varied from -10.5 to -27.0 (mean, -22.06; 95% CI, -21.5 to -22.5). Radial strain (RS) normal mean values varied from 24.9 to 62.1 (mean, 45.4; 95% CI, 43.0 to 47.8). Meta-regression showed LV end diastolic diameter as a significant determinant of variation for LS. Longitudinal systolic strain rate (LSRs) was significantly determined by the age and RS by the type of vendor used.

Conclusion

Variations among different normal ranges were dependent on the vendor used, LV end-diastolic diameter and age. Vendor-independent software for analyzing myocardial deformation in children, using images from different vendors would be the ideal solution for strain measurements or else using the same system for patient’s follow up.

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Title: Normal ranges of left ventricular strain in children: a meta-analysis
Authors: Haki Jashari
Annika Rydberg
Pranvera Ibrahimi
Gani Bajraktari
Lindita Kryeziu
Fisnik Jashari
Michael Y. Henein
Publication date: 01-12-2015
Publisher: BioMed Central
Published in: Cardiovascular Ultrasound / Issue 1/2015
Electronic ISSN: 1476-7120
DOI: https://doi.org/10.1186/s12947-015-0029-0

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