Left Ventricular Layer-Specific Strain by 2D Speckle-Tracking Echocardiography in Pediatric Myocarditis

Introduction: Myocarditis is an inflammatory disease of the myocardium with variable clinical presentation and challenging diagnosis, particularly in children with preserved left ventricular ejection fraction. Layer-specific strain analysis using speckle-tracking echocardiography allows separate assessment of endocardial, mid-myocardial, and epicardial deformation. We aimed to evaluate layer-specific strain in pediatric patients with acute myocarditis to determine whether layer-specific deformation parameters detect subclinical myocardial dysfunction.Results: Twenty-one pediatric patients with acute myocarditis (mean age 188.1 ± 22.8 months; 17 male) and 20 age- and sex-matched healthy controls were enrolled. Two-dimensional and speckle-tracking echocardiography with layer-specific strain analysis were performed. Global longitudinal strain and layer-specific longitudinal strain were measured at basal, mid-ventricular, and apical levels in endocardial, mid-myocardial, and epicardial layers.Patients with myocarditis had lower left ventricular ejection fraction compared to controls (%63 ± 3.4 vs %71.2 ± 1.9, p