Objectives .– Little is known about parameters of systolic left ventricular (LV) function using speckle tracking (ST) in children. The aim of this study was to define the feasibility (F) and reproducibility (R) of tissue motion annular displacement of mitral valve (TMAD) in healthy children (HC), in children with heart disease (HD) and assess the correlations between TMAD and usual LV systolic function parameters (LVSFP).

Methods .– We prospectively included 22 children with HD (13 boys, mean age 104 months) and 22 HC (12 boys, mean age 116 months). In an apical four chambers view, one region of interest (ROI) was placed at the septal and lateral parts of the mitral annulus and one at the apex. The displacement of the midpoint between the two annular ROIs toward the apex was automatically calculated by QLAB 9 ^® software (Philips).

Results .– TMAD indexed F was 100% (CI95% 94.8–100%) in children with and without HD and 86% (CI95% 71.5–100%) in healthy children. F of TMAD was not significantly different between HC and children with HD. Intraobserver variability (V) of TMAD was respectively 19% and 11% in HC and in children with HD. Interobserver V of TMAD was respectively 19% and 16% in HC and in children with HD. TMAD was not correlated to age nor to body surface area (BSA) nor to LV ejection fraction in HC whereas indexed TMAD was correlated to stroke volume ( r = 0.591, p = 0.0122), cardiac index ( r = 0.532, p = 0.0241), indexed TAPSE ( r = 0.691, p = 0.0034) and conversely correlated to end-diastolic (ED) LV diameter ( r = −0.677, p = 0.0041), to EDLV volume ( r = −0.629, p = 0.0076) and to end-systolic LV volume ( r = −0.616, p = 0.0090) in HC.

Conclusion .– TMAD seems an easy measurable marker with an excellent F and R to assess the mitral annular displacement. It seems independent of BSA and well correlated with stroke volume. The advantage of TMAD over tissue Doppler imaging relies on the independence on angle and measurement of strain vectors not parallel to the ultrasound beam. TMAD is an interesting tool in children. Its accuracy to estimate systolic function needs to be further investigated in children.