Pediatric ranges of normality for 2D speckle‐tracking echocardiography atrial strain: differences between p‐ and r‐gating and among new (Atrial Designed) and conventional (Ventricular Specific) software's.

Background: 2D speckle tracking echocardiography (STE) atrial strain (ε) analysis in children is gaining interest; however, pediatric nomograms remain limited. Comparison among conventional software's (designed for left ventricle and adapted to atria and using R‐gating analysis) and new software's (designed for atria and allowing for both R‐ and P‐gating) are lacking. The present study aims to establish pediatric nomograms for atrial ε using an atrial dedicated software and to compare values obtained by (a) R‐ and P‐gating and, (b) R‐gating with new and conventional software. Methods: Echocardiographic measurements included STE left (LA) and right (RA) atrial longitudinal reservoir, conduit and contractile ε. Age/weigh/height/heart rate, and body surface area (BSA) were used as independent variables in the statistical analysis. Results: In all, 580 healthy subjects (age range, 31 days‐18 years; mean age 7.5 years; median age 7.1 years; inter‐quartile range, 4.3–10.7 months; 45.5% female) were included. Feasibility of atrial ε measurements was high (98.9–96.8%). At lower age, atrial conduit ε was lower (p<0.001) while contractile ε was higher (p<0.001). All atrial ε values calculated with P‐gating method were lower—than R‐gating values (p<0.001). R‐gated LA ε reservoir values generated with the new software were lower, and R‐gated RA contractile ε higher than with the conventional software (p<0.011). Conclusion: We report pediatric atrial ε values from a dedicated atrial software. Maturational changes in STE atrial ε values were demonstrated. Significant differences were observed among ε values obtained with P‐ and R‐gating and with different software's. [ABSTRACT FROM AUTHOR]