Assesment of Right Ventricle Function with Speckle Tracking Echocardiography after the Percutaneous Closure of Atrial Septal Defect.

BACKGROUND: Transthoracic echocardiography is used for assessment of right ventricular (RV) function. Speckle tracking echocardiography (STE) is a new tool to assess myocardial function. The aim of this study was to evaluate RV function using STE in patients with atrial septal defect (ASD) before and the first month after percutaneous closure.

METHODS: We prospectively examined 32 consecutive patients (9 male, 23 female) who underwent percutaneous transcatheter closure (PTC) of secundum ASD from June 2013 to December 2015. Echocardiography was initially performed upon admission, prior to cardiac catheterization and then the first month after PTC of secundum ASD. Thereafter, the peak global RV longitudinal strain (RVLSR) was analyzed by two-dimensional STE.

RESULTS: The mean age of the patients was 34.6 ± 8.2 years, and the mean diameter of the occlusive devices was 18.5 ± 7.5 mm. RV end diastolic diameters were significantly larger and decreased significantly after ASD closure (43 ± 5 vs. 38 ± 4 mm, p < 0.05). Left atrium diameters (40 ± 8 vs. 37 ± 6 mm, p < 0.05) decreased significantly after the intervention, whereas left ventricle end-diastolic diameters (45 ± 5 vs. 46 ± 4 mm, nonspecific) remain unchanged. Tricuspid annular plane systolic excursion increased significantly (17.6 ± 5.4 vs. 22.3 ± 8.1 mm, p < 0.05). RV myocardial performance index significantly improved (0.38 ± 0.15 vs. 0.29 ± 0.08, p < 0.05). After interventional closure of the defect, we observed a significant increase of the longitudinal RV strain (28.3 ± 5.6% vs. 22.4 ± 4.3%, p < 0.001).

CONCLUSIONS: Two-dimensional strain appears to facilitate the assessment of RV function and its response to correction of volume overload after PTC of secundum ASD.