# Blood speckle tracking to predict functional status in pediatric patients with dilated cardiomyopathy

## TL;DR

This study explores blood speckle tracking as a potential method to assess heart function in children with dilated cardiomyopathy, finding it more effective than traditional measures.

## Contribution

The study introduces blood speckle tracking as a novel echocardiographic method to differentiate functional status in pediatric DCM patients.

## Key findings

- LV GLS, GAS, and EF failed to distinguish NYHA II and III DCM patients.
- PSI and systolic vortex formation showed significant differences between NYHA II and III subgroups.
- A PSI cut-off >4% was 92% sensitive in predicting worse clinical manifestations.

## Abstract

Dilated Cardiomyopathy (DCM) is an important cause of significant cardiac functional impairment in pediatric patients. There is to date debate on which echocardiographic variable correlates better with the functional status of the patient.

28 DCM patients (NYHA class II and III), and 30 controls were enrolled in the study, where advanced echocardiographic examination was used to assess LV (Left ventricular) function. Tissue Doppler, 2D speckle tracking for PSI (post-systolic strain index calculation), and blood speckle tracking for the timing of LV vortex formation were implemented.

Intriguingly, none of LV GLS and GAS (Global longitudinal and area strain), or EF (Ejection fraction, were able to differentiate NYHA II and III subgroups of cases. In contrast, PSI, and systolic vortex formation were significantly different between subgroups of cases; systolic vortex was seen in 33% of NYHA II patients compared to 77% of NYHA III patients, a PSI median value of 5% was seen in NYHA III cases, and a cut-off >4% was 92% sensitive in predicting worse manifestations.

Dyssynchrony; seems to play a significant role in orchestrating symptoms of heart failure. In this context, blood speckle tracking study seems a promising bedside method, in its assessment. A large room for improvement and systemization of its assessment is still needed to objectivize its use.

The online version contains supplementary material available at 10.1186/s12872-025-04984-2.