Assessing early left ventricular remodeling in pediatric hypertension: A study using transthoracic echocardiography combined with two‐dimensional speckle tracking echocardiography in an immature rabbit model

Author:

Feng Lingxin123ORCID,Zhu Xu14,Ji Xiaojuan15,Zhu Huiru12,Ran Tingting6,Yang Haiyan5

Affiliation:

1. Department of Ultrasound Children's Hospital of Chongqing Medical University National Clinical Research Center for Child Health and Disorders Ministry of Education Key Laboratory of Child Development and Disorders Chongqing China

2. Chongqing Key Laboratory of Pediatrics Chongqing China

3. State Key Laboratory of Ultrasound in Medicine and Engineering Chongqing Medical University Chongqing China

4. Department of Ultrasound The Third Affiliated Hospital of Chongqing Medical University Chongqing China

5. Department of Ultrasound Chongqing General Hospital Chongqing University Chongqing China

6. Department of Ultrasound Chongqing Health Center for Women and Children Women and Children's Hospital of Chongqing Medical University Chongqing China

Abstract

AbstractThis study explored the value of routine transthoracic echocardiography (TTE) combined with two‐dimensional speckle tracking echocardiography (2D‐STE) for the early evaluation of left ventricular remodeling in the hypertensive immature rabbit model. Twenty‐seven New Zealand white rabbits were divided into Group A (sham‐operated group), Group B (mild group), and Group C (severe group), with 9 rabbits per group. The hypertension model was constructed using the “two kidneys one clip” method. Changes in left ventricular function and the degree of left ventricular wall thickening were observed by TTE at 1, 4, and 8 weeks after modeling. The global longitudinal strain (GLS‐AVG, GLS‐A4C, GLS‐A2C, and GLS‐LAX) of the left ventricle (LV) and the longitudinal strain (LS) of the 18 segments of left ventricular myocardium were analyzed using 2D‐STE. Concurrently, LV myocardial tissue was sampled for HE staining and Masson staining. Receiver operating characteristic (ROC) curves were plotted to evaluate the accuracy of 2D‐STE parameters in predicting myocardial fibrosis. The model group exhibited varying degrees of left ventricular remodeling. GLS‐A4C, GLS‐A2C, GLS‐LAX, and GLS‐AVG in the model group increased at 1 week after modeling (P < 0.01), with LS abnormalities concentrated in the apical segments. GLS‐AVG showed a significant positive correlation with both IVSd and CVF (P < 0.01). The area under the curve (AUC) values of GLS‐AVG, GLS‐A4C, GLS‐A2C, and GLS‐LAX were 0.850, 0.827, 0.839, and 0.800, respectively. This study demonstrates the promise of TTE combined with 2D‐STE for the early and comprehensive evaluation of left ventricular myocardial damage in hypertensive children in the clinical setting.

Publisher

Wiley

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