Predictors and outcomes of early left ventricular dysfunction in paediatric patients postoperative for ventricular septal defect: a retrospective cohort study based on myocardial strain and work.

@article{zhao2026predictors,
  title = {{Predictors and outcomes of early left ventricular dysfunction in paediatric patients postoperative for ventricular septal defect: a retrospective cohort study based on myocardial strain and work.}},
  author = {Wanyu Zhao and Weijun Li and Tao Wang and Lang Gao and Jinnan Zhang and Qiuzhe Guo and Yifei Zhang and Lulu Zhang and Shuanglan Yu and Xiaoli Dong and Jingjin Wang and Zhiling Luo},
  journal = {BMC pediatrics},
  year = {2026},
  month = aug,
  doi = {10.1186/s12887-026-07470-6},
  url = {https://europepmc.org/article/MED/42958113},
  note = {CC BY-NC-ND},
}

TY  - JOUR
TI  - Predictors and outcomes of early left ventricular dysfunction in paediatric patients postoperative for ventricular septal defect: a retrospective cohort study based on myocardial strain and work.
AU  - Wanyu Zhao
AU  - Weijun Li
AU  - Tao Wang
AU  - Lang Gao
AU  - Jinnan Zhang
AU  - Qiuzhe Guo
AU  - Yifei Zhang
AU  - Lulu Zhang
AU  - Shuanglan Yu
AU  - Xiaoli Dong
AU  - Jingjin Wang
AU  - Zhiling Luo
PY  - 2026
DA  - 2026/08/01
JO  - BMC pediatrics
DO  - 10.1186/s12887-026-07470-6
UR  - https://europepmc.org/article/MED/42958113
AB  - Background: Early postoperative left ventricular (LV) dysfunction commonly occurs after ventricular septal defect (VSD) repair in paediatric patients. This study aimed to investigate its risk factors and impact on follow-up cardiac functional status.  Methods: We retrospectively enrolled patients with preserved LV ejection fraction (LVEF) ≥ 55% undergoing isolated surgical VSD repair. Early postoperative LV dysfunction was defined as LVEF < 55% during hospitalisation. LV function parameters including myocardial strain and work were obtained. Cardiac functional recovery was assessed at 1, 3, 6, and 12 months post-discharge based on Ross Classifications.  Results: The cohort comprised 409 patients (3.00 [1.00–5.75] years; 50.4% male), with 82 (20.05%) developing postoperative LV dysfunction. Multivariate analysis showed that preoperative LV global longitudinal strain (LV GLS), global work index (LV GWI), global work efficiency (LV GWE), LV end-diastolic volume index (LVEDVi), moderate-to-severe sPAP, and large VSD size, as well as prolonged cardiopulmonary bypass (CPB) time, were significantly associated with postoperative LV dysfunction (all p < 0.05). ROC analyses found that integrating LV GWI and GWE with clinical parameters (LVEDVi, VSD size, or sPAP) enhanced prediction (AUC 0.848–0.883, P < 0.001). During follow-up, patients with postoperative LV dysfunction exhibited less favourable Ross classification recovery at 12 months after surgery.  Conclusions: Myocardial strain and work indices were related to early postoperative LV dysfunction in paediatric patients after isolated VSD repair, which was correlated with persistent symptoms and cardiac dysfunction at 12-month follow-up. Pre- and postoperative LV function assessment may offer useful information for managing this patient population.  Registration: https://www.chictr.org.cn/; Unique identifien ChiCTR2400092501 Retrospectively registered 18 November 2024.  Graphical abstract: LV, left ventricular; LVEF, left ventricular ejection fraction; LVEDVi, left ventricular end-diastolic volume index; sPAP, systolic pulmonary arterial pressure; VSD, ventricular septal defect; GLS, global longitudinal strain; GWI, global work index; GWE, global work efficiency  Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12887-026-07470-6.
SN  - 1471-2431
ER  -