Objectives .– New parameters of systolic left ventricular (LV) function using speckle tracking echocardiography (STE) are available. Little is known about the accuracy of these parameters in children. The aim of this study was to define the feasibility (F) and reproducibility (R) of systolic peak left ventricular twist (pLVT) in healthy children (HC) and in children with heart disease (HD). We also aimed to assess the correlations between left ventricular twist pLVT and usual SLVF parameters.

Methods .– We included in this prospective study 22 children with HD (13 boys, mean age 104 months) and 22 HC (12 boys, mean age 116 months). pLVT (difference between maximal apical rotation and maximal basal rotation on para-sternal views) was measured off-line workstation (Qlab ^® 9, Philips). F were compared within the two groups.

Results .– pLVT F was 77% (CI95% 59.4–94.6%) in patients and 64% (CI95% 43.9–84.1%) in HC. F of pLVT was not significantly different between children with or without cardiopathy. Intraobserver variability (V) of pLVT was 43% in patients and 41% in HC. Interobserver V of pLVT was 39% in patients and 36% in HC. pLVT was correlated to body surface area ( r = 0.631, P = 0.0229). Indexed pLVT was significantly correlated to Simpson’s LV ejection fraction ( r = 0.678, P = 0.0146) and conversely correlated with indexed end-systolic LV volume ( r = −0.604, P = 0.0293) in HC unlike non-indexed pLVT. pLVTt and indexed pLVT were not correlated to mitral annular mean maximal tissular Doppler imaging velocity.

Conclusion .– Despite a promising concept to assess systolic LV function, F of pLVT is currently low in child with HD and also in HC. Intra and inter observer V are high. The high heart rate V and the difficulty to acquire echo loops without any movement in children may be the limiting factors. Therefore, it seems too early to extend the use of these parameters in clinical practice. The improvement of STE and a thorough formation of operators are probably necessary before using this new promising parameter in clinical practice.