Three-Dimensional Strain for Left Ventricular Function Assessment in Children After Successful Ventricular Septal Defect Repair

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Abstract
Background: Ventricular septal defect (VSD) has a good prognosis after surgical treatment. Three-dimensional (3D) strain echocardiography is a novel method adapting AI for assessing ventricular function; however, its utility remains to be tested. The aim of the study was to assess accuracy of 3D strain echocardiography based on a specific population of patients. Methods: The study enrolled children after successful surgical VSD treatment. In all patients, 3D echocardiography was performed to assess left ventricular ejection fraction (LVEF) and global and segmental longitudinal (LS), circumferential (CS), and radial strain (RS) values. The results were compared with those of healthy individuals matched for age and sex. Results: The study group consisted of 20 children (12 males) aged 3–17 years (mean 7.0 ± 4.3 years), with normal ventricular function on routine 2D echocardiography. The global strain values in all patients were within the standard range in the literature for sex and age. Statistically significant differences between study and control groups were observed in terms of LVEF (55.6 ± 6.9% vs. 59.3 ± 4.8%, p = 0.046), global LS (−21.4 ± 4.3 vs. −24.8 ± 3.5, p = 0.010), and RS (38.7 ± 6.1% vs. 43.6 ± 5.0%, p = 0.010). Segmental strain values showed dysfunction limited to the patched septal area. Conclusions: 3D strain echocardiography is able to detect regional subclinical cardiac function impairment in children after successful surgical treatment of VSD.

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