GP38 Speckle tracking as a modern echocardiographic technique in assessing cardiac function in children

Introduction Speckle tracking is a new method of assessing cardiac function in adults, but used only at a research level in children. The aim is to implement this method in children with congenital and acquired cardiac pathology and oncologic disease as a new method of detecting cardiac function deterioration. Methods and material We selected patients with congenital or acquired heard disease and oncologic pathology then performed echocardiography, cardiac biomarkers and speckle tracking and compared the results. Results Currently we have 31 patients out of which 55% had a cardiac pathology, 26% had an oncological disease and 19% were collagenases or vasculitides. However, the study is ongoing and we hope to achieve a larger patient pool. When considering the patients with congenital heart disease 47% had modified GLS(global longitudinal strain) and cardiac biomarkers, but a normal EF(ejection fraction). Aortic coarctation, aortic regurgitation, complex cyanogenic malformations, ventricular septal defect, complete AV block, hypertrophic cardiomyopathy and dilated cardiomyopathy were the maladies with altered GLS but with normal ejection fraction. In the case of the complete AV block, she had a new dual chamber pacemaker installed, after which she developed symptoms of cardiac failure, GLS was under normal values, EF was 54% and had a septal dyssynchrony, however after modifying the device’s parameters the GLS was normal and there was no septal dyssynchrony. Patients with chemotherapy frequently develop cardiac toxicity. 44% of patients were diagnosed with cardiotoxicity with the help of speckle tracking and cardiac biomarkers. One patient with Rhabdomyosarcoma with an initial normal GLS, chemotherapy was initiated, after which he accused palpitations. The GLS was at the lower normal limit, thus confirming cardiotoxicity due to Doxorubicin. One patient with LES was monitored by speckle tracking. Initial normal GLS, was altered during a disease flare after which pericarditis developed. We had two patients with Kawasaki disease complicated with severe coronary aneurysms which were followed-up by speckle tracking. Conclusions Speckle tracking can be used as a fast and safe method to determine cardiac function in children, being well correlated with cardiac biomarkers, even when EF is normal.