SynthesisEchocardiography (Mount Kisco, N.Y.)2026
The Utility of Strain Echocardiography in the Diagnosis of Pediatric Myocarditis: A Systematic Review and Meta-Analysis.
Synthesis in Echocardiography (Mount Kisco, N.Y.), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeThe clinical presentation of pediatric myocarditis is heterogeneous, and diagnosis can be elusive. Diagnostic criteria feature cardiac magnetic resonance (CMR) as the imaging gold-standard, but this is not always feasible. Strain echocardiography has been shown to aid in the diagnosis of suspected myocarditis. This report aimed to synthesize available literature regarding the use of strain echocardiography for the diagnosis of pediatric myocarditis, and to systematically review the concordance between strain echocardiography and CMR (PROSPERO CRD42024596691).
methodsA systematic search of MEDLINE, Embase, and Scopus was conducted up to July 2025 to identify studies describing strain echocardiography for diagnosis of pediatric myocarditis, and thereby estimate mean differences (MDs) in conventional and strain echocardiographic values between pediatric myocarditis and controls.
resultsSeven studies were included (three case-control [myocarditis n = 119, control n = 50] and four cohort [n = 101]). The MD in left ventricular ejection fraction (LVEF) and global longitudinal strain (LV-GLS) between pediatric myocarditis and controls was -4.3% (-10.5% to 1.9%) and -5.2% (-7.7% to -2.8%), respectively. The mean pooled LVEF and LV-GLS for the pediatric myocarditis population was 61.9% (58.1% to 65.6%) and -17.0% (-19.3% to -14.8%), respectively. Subgroup analysis on LVEF status (normal vs. abnormal) showed differences in mean LVEF (p = 0.042), but not in the mean LV-GLS (p = 0.583). Throughout reports which included CMR imaging, strain echocardiography reliably and consistently identified CMR-positive myocardial injury.
conclusionStrain echocardiography is a valuable tool for the assessment of suspected pediatric myocarditis, showing good concordance with CMR and identifying myocardial dysfunction before conventional echocardiographic measures decline.
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