Evaluating the myocardial functions of the forgotten right ventricle in children with nephrotic syndrome utilizing traditional echocardiography, two-dimensional speckle tracking and three-dimensional echocardiography

Abstract Background Primary nephrotic syndrome (NS) is associated with systemic effects that may impact cardiac function, although several studies have explored left ventricle in children with NS. Few studies investigated right ventricle (RV) in this disease. Therefore, the study aimed to provide a comprehensive evaluation of RV functions in children with primary NS using echocardiography. Methods A case-control observational study was conducted from January 2022 to August 2024 on 40 primary NS patients with steroid-resistant nephrotic syndrome (SRNS) and steroid-sensitive nephrotic syndrome (SSNS), alongside 40 healthy controls. All participants underwent RV assessments using conventional parameters, tissue Doppler imaging (TDI), two-dimensional speckle-tracking echocardiography (2D STE), and three-dimensional echocardiography (3DE). Results Significantly lower s’, e’ in NS patients compared to controls, especially lower in SRNS compared to SSNS. Significantly higher E/e’ and Tei index was detected in the NS group compared to controls (p =  Conclusions Integrative use of variable echocardiographic modalities allows detection of subclinical alterations in RV function in children with primary NS, with more affected parameters in SRNS. Therefore, regular surveillance of RV functions in primary NS should be considered.