Evaluation of Myocardial Function in Children with Vasovagal Syncope Using Speckle-Tracking Echocardiography

Objective: Syncope is a transient, sudden and reversible loss of consciousness caused by cerebral hypoperfusion.The most common type of childhood syncope is neurally mediated syncope, with more than 50% of cases suffer from vasovagal syncope (VVS).Although VVS is commonly seen during both childhood and adulthood, its underlying pathogenesis and prognosis are still unclear.We have aimed to evaluate both left ventricular (LV) and left atrial myocardial function in children with VVS using twodimensional speckle-tracking echocardiography (2D-STE) during the non-syncopal period. Method:The study population included patients under the age of 18 years diagnosed with VVS based on patient history and physical examination findings.Cases with structural heart disease, arrhythmia, or syncope due to metabolic or neurological causes were excluded.The control group consisted of healthy children without systemic diseases.Results: A total of 36 children with VVS and 36 healthy controls were included.No significant differences were found between the groups regarding age, gender, body mass index, systolic/diastolic blood pressure and heart rate.Conventional echocardiographic measurements showed no differences between both groups in terms of LV volume, systolic and diastolic functions.However, LV global longitudinal and circumferential strain, left atrial peak strain values were lower in the VVS group.LV global longitudinal strain, circumferential strain, and left atrial strain were significantly associated with the presence of syncope. Conclusion:The study demonstrated that myocardial performance parameters are affected in children with VVS.In addition to conventional echocardiography, evaluation of cardiac functions with 2D-STE imaging will provide important information for these patients.