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Peer-reviewedCC BY 4.0Frontiers in Cardiovascular Medicine

Long-term myocardial deformation abnormalities and biomarker associations in pediatric myopericarditis: a speckle-tracking echocardiographic study

  • Sule Arici1
  • Selen Karagozlu2
  • Elif Erolu Kibris3
  • Figen Akalın2
  1. 1Department of Pediatric Cardiology, Kosuyolu Yuksek Ihtisas Egitim ve Arastirma Hastanesi
  2. 2Department of Pediatric Cardiology, Marmara Universitesi Tip Fakultesi
  3. 3Department of Pediatric Cardiology, Ankara Etlik Entegre Saglik Kampusu
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Abstract

Background and objectives: Subclinical myocardial deformation abnormalities may be detectable during long-term follow-up in pediatric patients with a history of myopericarditis despite apparently normal conventional echocardiographic findings. This study aimed to comprehensively evaluate long-term myocardial deformation abnormalities using speckle-tracking echocardiography and to assess their associations with acute-phase inflammatory and cardiac biomarkers.

Methods: Thirty pediatric patients with a history of myopericarditis and 22 age- and sex-matched healthy controls were included. Acute-phase clinical, laboratory, electrocardiographic, and echocardiographic data were retrospectively collected. At long-term follow-up, comprehensive echocardiographic evaluation including tissue Doppler imaging and speckle-tracking–derived longitudinal and circumferential strain analysis was prospectively performed. Associations between acute-phase biomarkers and long-term echocardiographic findings were analyzed.

Results: At a mean follow-up of 32.8 ± 12.0 months, patients demonstrated significantly reduced global longitudinal strain (−12.43 ± 6.67% vs. −17.77 ± 1.94%, p < 0.001) and global circumferential strain (−16.04 ± 12.50% vs. −25.14 ± 4.73%, p = 0.002) compared with controls despite largely preserved conventional systolic function. Segmental longitudinal and circumferential strain parameters were also impaired, accompanied by increased time-to-peak strain dispersion. Higher neutrophil-to-lymphocyte ratio and systemic immune-inflammation index values correlated with less negative global longitudinal strain values, while CRP correlated with impaired global circumferential strain.

Conclusions: Pediatric patients with a history of myopericarditis may exhibit subclinical myocardial deformation abnormalities at long-term follow-up despite apparently preserved conventional echocardiographic findings. Speckle-tracking echocardiography may provide incremental value for detecting subtle myocardial deformation abnormalities beyond conventional systolic assessment. Exploratory associations were observed between acute-phase inflammatory biomarkers and long-term myocardial deformation parameters; however, larger prospective studies are needed to clarify whether these findings have causal or clinical significance.

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Cite

BibTeXRIS
BibTeX
@article{arici2026longterm,
  title = {{Long-term myocardial deformation abnormalities and biomarker associations in pediatric myopericarditis: a speckle-tracking echocardiographic study}},
  author = {Sule Arici and Selen Karagozlu and Elif Erolu Kibris and Figen Akalın},
  journal = {Frontiers in Cardiovascular Medicine},
  year = {2026},
  month = oct,
  doi = {10.3389/fcvm.2026.1938858},
  url = {https://www.frontiersin.org/articles/10.3389/fcvm.2026.1938858/full},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Long-term myocardial deformation abnormalities and biomarker associations in pediatric myopericarditis: a speckle-tracking echocardiographic study
AU  - Sule Arici
AU  - Selen Karagozlu
AU  - Elif Erolu Kibris
AU  - Figen Akalın
PY  - 2026
DA  - 2026/10/28
JO  - Frontiers in Cardiovascular Medicine
DO  - 10.3389/fcvm.2026.1938858
UR  - https://www.frontiersin.org/articles/10.3389/fcvm.2026.1938858/full
AB  - Background and objectives: Subclinical myocardial deformation abnormalities may be detectable during long-term follow-up in pediatric patients with a history of myopericarditis despite apparently normal conventional echocardiographic findings. This study aimed to comprehensively evaluate long-term myocardial deformation abnormalities using speckle-tracking echocardiography and to assess their associations with acute-phase inflammatory and cardiac biomarkers.  Methods: Thirty pediatric patients with a history of myopericarditis and 22 age- and sex-matched healthy controls were included. Acute-phase clinical, laboratory, electrocardiographic, and echocardiographic data were retrospectively collected. At long-term follow-up, comprehensive echocardiographic evaluation including tissue Doppler imaging and speckle-tracking–derived longitudinal and circumferential strain analysis was prospectively performed. Associations between acute-phase biomarkers and long-term echocardiographic findings were analyzed.  Results: At a mean follow-up of 32.8 ± 12.0 months, patients demonstrated significantly reduced global longitudinal strain (−12.43 ± 6.67% vs. −17.77 ± 1.94%, p < 0.001) and global circumferential strain (−16.04 ± 12.50% vs. −25.14 ± 4.73%, p = 0.002) compared with controls despite largely preserved conventional systolic function. Segmental longitudinal and circumferential strain parameters were also impaired, accompanied by increased time-to-peak strain dispersion. Higher neutrophil-to-lymphocyte ratio and systemic immune-inflammation index values correlated with less negative global longitudinal strain values, while CRP correlated with impaired global circumferential strain.  Conclusions: Pediatric patients with a history of myopericarditis may exhibit subclinical myocardial deformation abnormalities at long-term follow-up despite apparently preserved conventional echocardiographic findings. Speckle-tracking echocardiography may provide incremental value for detecting subtle myocardial deformation abnormalities beyond conventional systolic assessment. Exploratory associations were observed between acute-phase inflammatory biomarkers and long-term myocardial deformation parameters; however, larger prospective studies are needed to clarify whether these findings have causal or clinical significance.
SN  - 2297-055X
ER  -