Assessment of Left Ventricular Function in Patients with Ventricular Septal Defect Using Speckle Tracking Echocardiography

Background: Up to 40% of all cardiac abnormalities are caused by ventricular septal defects (VSD), the most prevalent congenital heart defect (CHD). Hemodynamic overload in children /with VSDs leads to myocardial damage and eventual heart failure. Conventional echocardiography cannot identify cardiac injury in its early stages. A more precise method for the early detection of cardiovascular disorders is speckle tracking echocardiography (STE), which was just introduced.
Aim of the work: This study aimed to assess the left ventricular function in patients with isolated VSD using speckle-tracking echocardiography (STE).
Patients and methods: The study was conducted on 30 patients with isolated VSD, with a mean age 9.02 ± 4.90 years, in addition to 20 healthy age- and sex-matched control group. The VSD group was further stratified according to age into two subgroups: Group A included 14 patients aged 2-8 years. Group B involved 16 patients aged 9-17 years. Echocardiography evaluation included M-mode, 2D, color Doppler, TDI and STE.
Results: In our study; LVGLS was significantly lower in patients with VSD (-20.43 ± 1.92) compared to the control group [(-21.61±1.27), p value<0.05]. Subgroup analysis revealed no significant difference regarding LV- GLS in group A (-21.07 ± 1.85) compared to their controls (-22.06 ± 1.32) (P=0.182). On the other hand, group B had significantly lower values of LV-GLS (-19.33 ± 1.85) compared to the normal group (-21.24 ± 1.16) (p = 0.039). LVGLS correlated negatively with the left atrial diameter (r = -0.38, P = 0.029), left ventricular dimensions (r = -0.416, P = 0.024), VSD size (r =-0.392, P=0.017), Qp/Qs ratio (r =-0.480, P=0.007) and age "years" (r=-0.513, P=0.004).
Conclusion: STE is a sensitive and valuable tool for the early detection and prediction of subclinical LV dysfunction in patients with VSD, even when conventional echocardiographic parameters appear normal.