Evaluation of the left ventricular systolic strain in hypocalcemic infants with two-dimensional speckle tracking echocardiography

Echocardiography. 2022 Apr;39(4):568-575. doi: 10.1111/echo.15329. Epub 2022 Feb 25.

Abstract

Introduction: Speckle tracking echocardiography (STE) is a new emerging method for evaluation of the cardiac systolic performance. We characterized left ventricular (LV) systolic functions of hypocalcemic infants, and assessed the effects of calcium and vitamin D supplementations on LV systolic functions using two-dimensional STE.

Patients and methods: A prospective controlled study was conducted in Mansoura University Children's Hospital, Egypt from 2015 to 2018 including 88 hypocalcemic infants (patient group) and 30 healthy controls. We subdivided the patient group into vitamin D deficiency group (n = 32) and normal vitamin D group (n = 56). All infants were investigated for serum phosphorus, alkaline phosphatase and 25-hydroxy vitamin D levels. Both patients and controls were initially evaluated for LV systolic functions using two-dimensional STE. After correction of hypocalcemia and vitamin D deficiency, reevaluation of LV systolic functions was done for the patient group.

Results: LV systolic strains were lower in the patient group than controls (p < .001). After recovery of hypocalcemia of the patients, we reported significant improvement of strains and significant reductions of the end-diastolic and end-systolic volumes of the left ventricle (p < .001). Global longitudinal and circumferential strains were lower in patients with vitamin D deficiency than patients with normal vitamin D levels (p < .001). The LV systolic strain improved after correction of vitamin D deficiency and hypocalcemia (p < .001).

Conclusion: Two-dimensional STE could detect and follow up early LV systolic dysfunction in infants with hypocalcemia and vitamin D deficiency.

Keywords: hypocalcemia; infants; left ventricular systolic strain; speckle tracking echocardiography; vitamin D.

MeSH terms

  • Child
  • Echocardiography / methods
  • Heart Ventricles / diagnostic imaging
  • Humans
  • Hypocalcemia* / complications
  • Infant
  • Prospective Studies
  • Ventricular Dysfunction, Left* / complications
  • Ventricular Dysfunction, Left* / diagnostic imaging
  • Ventricular Function, Left
  • Vitamin D
  • Vitamin D Deficiency* / complications

Substances

  • Vitamin D