Applications of speckle tracking echocardiography in paediatric and congenital heart disease: an expert consensus paper from AEPC Imaging Working Group

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Abstract
This document has been developed to provide a practical guide for the application of speckle tracking echocardiography (STE) in paediatric and congenital heart diseases. In the present document, the following topics are reviewed and discussed: (i) the basic principles of STE, its potential applications, and limitations in the paediatric population; (ii) normal paediatric reference values for STE; and (iii) the use of STE in various congenital and acquired heart diseases. The potential role of routine STE in the management and follow-up of paediatric and congenital heart disease is explored, with practical examples illustrating how STE can provide additional insights beyond conventional echocardiographic parameters. Limitations regarding clinical interpretation, prognostic value, the lack of standardized timing for measurements, and the absence of universally accepted thresholds for STE-derived strain parameters are also highlighted. Overall, this document is intended to serve as a comprehensive guide to (i) orient clinicians regarding the strengths and limitations of STE in paediatric and congenital heart disease; (ii) identify specific clinical scenarios where STE may be particularly informative; and (iii) encourage future research and multicentre collaborative studies. By providing both practical guidance and a framework for further investigation, the document aims to support standardized use of STE, improve patient care, and foster the integration of this technique into routine paediatric and congenital cardiology practice.

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