Right and Left Ventricular Strain and Strain Rate in Young Adults before and after Percutaneous Atrial Septal Defect Closure

Abstract

To evaluate acute change of right and left ventricle after percutaneous closure of isolated atrial septal defect (ASD) 21 adult patients (13 F; 8 M) aged 28 ± 9.5 range 18-49 years have been examined by echocardiography before and 24 hours after percutaneous closure of ASD. Twenty-one normal adult subjects, as control group were included. A MyLab25 echo machine equipped with a multifrequency 2.5-3.5 MHz transducer was used. Offline computer-based analysis for strain and SR were performed using XStrain software based on a feature tracking algorithm. All patients had ASD OS2 with right ventricular dilatation and diastolic areas were larger than in controls: P = 0.0158. Global right ventricular longitudinal strain was higher P = 0.0438. Twenty-four hours after ASD closure, right ventricular diastolic and systolic areas were significantly reduced. Right ventricular global longitudinal systolic strain decreased: P = 0.00016, as well as global right ventricular longitudinal SR -1.56/sec ± 0.57 vs. -1.28/sec ± 0.31, P = 0.02646. At the mean time left ventricular end diastolic volume and left ventricular cardiac output measured by two-dimensional echocardiography both increased significantly P = 0.002145 and 0.013409. Global circumferential strain at mitral level augmented significantly -20.3%± 4.64 vs. -25.39%± 5.22, P = 0.00003. Longitudinal strain of the right ventricle works as indicator of right ventricular function dependent on loading conditions while SR seems to be less dependent on it. Circumferential strain could be used as an indicator of left ventricular response to normalized loading conditions.

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

“…Cerrahi kapatılmasından sonra zaman içinde sol ventrikül dilatasyonu geriler. Hacim değişiklikleri ile kardiyak fonksiyonlarda oluşan değişiklikler sıklıkla atriyal septal defekt kapatılması sonrası değerlendirilmiştir (12)(13)(14)(15). Ventriküler septal defektlerin perkütan kapatılması ile miyokardiyal gerilme kuvvetleri arasındaki ilişkiyi araştıran bir çalışma hem yetişkin hemde çocukluk çağında halen gerçekleştirilmemiştir.…”

“…Strain görüntüleme kardiyak iskemi, infarkt patofizyolojisini anlamada, kalp kas hastalıklarını değerlendirmede, kapak hastalıklarının miyokardiyal dokuya etkisini izlemede, diyastolik fonksiyonların daha iyi anlaşılmasında kullanılabilir. Ayrıca aktif olarak kardiyak resenkronize pil tedavisinde kullanılmaktadır (15). Strain ve SRI ölçümleri, gürültü ve ölçüm hatalarını daha da azaltan, açıdan bağımsız "speckle tracking" metodla daha da hassas olarak ölçülebilir (16,17).…”

“…(15), transkateter atriyal septal defekt kapatılması yapılan 21 hastada işlem sonrası sağ ventrikül longitidunal strainin anlamlı derecede arttığını ama SRI değerlerinin artmadığını çalışmalarında göstermişlerdir. Yazarlar, bu sonucu strainin hacim değişikliklerine daha hassas olduğu şeklinde yorumlamışlardır (15). Di Salvo ve ark.…”

Echocardiographic Evaluation of Congenital Cardiopathies Before and After Intervention

“…The complexity of the right ventricle morphology, with its bellow shape and trabeculations, makes the calculation and ejection fraction difficult. New parameters based on strain measurement (see Chapter 10) seem to hold more promise for the evaluation of right ventricular function, an important determinant for postintervention prognosis [24][25][26]. Inclusion and exclusion criteria of right ventricle function status could be established, thus avoiding performing PBV in dogs with irreversible right ventricular dysfunction.…”

Advanced Echocardiographic Imaging of the Congenitally Malformed Heart

“…In adult patients STE has shown interesting changes in right and left ventricular deformation following percutaneous closure of atrial septal defects [44]. RV global longitudinal strain decreased significantly following closure and LV circumferential strain increased significantly correlating with an increase in LVEDV and LVCO.…”