Assessment of right ventricular function by three-dimensional echocardiography and myocardial strain imaging in adult atrial septal defect before and after percutaneous closure

Abstract

Real-time three-dimensional (3D) echocardiography allows us to measure right ventricular (RV) end-diastolic volume irrespective of its shape. Tissue Doppler imaging (TDI) and speckle tracking imaging (STI) are new tools to assess myocardial function. We sought to evaluate RV function by 3D echocardiography and myocardial strain imaging in adult patients with atrial septal defect (ASD) before and 6 months after transcatheter closure in order to assess the utility of these new indexes in comparison with standard two-dimensional (2D) and Doppler parameters. Thirty-nine ASD patients and 39 healthy age- and sex-matched controls were studied using a commercially available cardiovascular ultrasound system. 2D-Doppler parameters of RV function (fractional area change, tricuspid annular plane systolic excursion, myocardial performance index) were calculated. 3D RV volumes were also obtained. RV peak-systolic velocities, peak-systolic strain, and peak systolic and diastolic strain-rate were measured in the basal, mid and apical segments of lateral and septal walls in apical 4-chamber view by TDI and STI. In open ASD, RV ejection fraction (3D-RVEF) and global and regional RV longitudinal strain were significantly higher than control group and decreased significantly after closure. By multivariate analysis 3D-RVEF, apical strain and strain rate were independent predictors of functional class. ROC analysis showed 3D-RVEF and apical strain to be more sensitive predictors of unfavorable outcome after defect closure compared to 2D-Doppler indexes. 3D echocardiography and myocardial strain imaging give useful insights in the quantitative assessment of RV function in ASD patients before and after closure.

Assessment of Right Ventricular Function in Obstructive Sleep Apnea Syndrome and Effects of Continuous Positive Airway Pressure Therapy: A Pilot Study

“…We have already shown in previous reports (26,28) that the newer technologies appear to be superior to the older technologies, including RVFAC, TAPSE, and MPI. Compared to RVFAC, MPI and TAPSE, 3D-RVEF had a stronger correlation with MRI, and the assessment of 3D-RVEF and RV strain allowed a better prediction of unfavorable outcome after ASD closure (26).…”

“…Compared to RVFAC, MPI and TAPSE, 3D-RVEF had a stronger correlation with MRI, and the assessment of 3D-RVEF and RV strain allowed a better prediction of unfavorable outcome after ASD closure (26). Moreover,…”

“…STE acquisitions were also obtained, with analyses being performed retrospectively and offline. The general principles that underlie STE modalities have been previously described (24)(25)(26)(27)(28)(29).…”

Intermediate Outcome of Transcatheter Closure of Secundum Atrial Septal Defect on Cardiac Remodeling in Egyptian Children and Adults

“…The increased myocardial strain values return to normal after ASD closure. Vitarelli et al [40] reported that RV longitudinal strain were significantly higher than control group before percutaneous closure and decreased significantly after closure [40].…”

Evaluation of regional left ventricular function with strain rate echocardiography at the percutaneous ventricular septal defect closure at the childhood

“…Viteralli ve arkadaşları (18), perkütan atriyal septal defekt kapatılan hastalarda üç boyutlu ekokardiyografi ile strain ve SRI değerlendirmesi yapmıştır. Kapatılma sonrası sağ ventrikülün ejeksiyon fraksiyonunda ve strain ölçümlerinde anlamlı azalma olduğunu göstermiştir (18). Bunun hakim yükünün azalmasına bağlı olduğunu söylemişlerdir.…”