Electrocardiographic strain pattern in children with left ventricular hypertrophy: A marker of ventricular dysfunction

Nishant Shah, Kavitha Chintala, Sanjeev Aggarwal

Research output: Contribution to journalArticlepeer-review

6 Scopus citations


The objective of this study was to assess the relation between strain pattern on electrocardiogram (ECG-strain) and echocardiographic indices of left ventricular (LV) structure and function in children with LV hypertrophy (LVH). ECG-strain is a marker of LVH and is associated with adverse cardiovascular prognosis in adults. The significance of ECG-strain and its relation to LV structure and function has not been studied in children. We retrospectively analyzed electrocardiograms (ECGs) and echocardiograms of 101 children enrolled in this study. Subjects were divided into three groups: group I (n = 21) comprised children with LVH confirmed by echocardiography (LVHecho) with ECG-strain pattern; group II (n = 54) comprised children with LVH echo without ECG-strain pattern; and group III (n = 26) comprised children without LVH (control group). ECG-strain was defined as a down-sloping convex ST-segment depression (≥0.1 mV) with an inverted asymmetrical T-wave opposite to the QRS axis in leads V5 and/or V6. LV structure and function was measured using conventional and tissue Doppler echocardiography. ECG-strain was associated with greater interventricular septal thickness, posterior wall thickness, and LV mass index (LVMI) compared with those without ECG-strain (P < 0.0001 for each variable). Concentric LVH was more common in those with ECG-strain (16 of 21 vs. 9 of 54 patients; P = < 0.0001). ECG-strain was associated with systolic, diastolic, and combined systolic-diastolic dysfunction in children with LVHecho. Among children with LVH, ECG-strain is associated with higher LVMI, concentric pattern of LVH, and LV systolic and diastolic dysfunction. Whether this has similar adverse prognostic implications as it does in adults remains to be determined.

Original languageEnglish (US)
Pages (from-to)800-806
Number of pages7
JournalPediatric cardiology
Issue number6
StatePublished - Aug 2010

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine
  • Pediatrics, Perinatology, and Child Health


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