ABSTRACT
Background: Atrial septal defects lead to left to right shunt, the volume of the shunt is determined by RV/LV compliance, defect size, and LA/RA pressure. RV volume overload and pulmonary over circulation are caused by a simple ASD because the RV is more compliant than the LV. The aim of our study was to assess changes in RV systolic function before and after ASD closure either by surgery or transcatheter closure. Methods: This study was conducted on 70 patients diagnosed with ASD Secundum and had subdivided into two groups A (surgical closure) group, and B (percutaneous device closure) group. All patients had been assessed by transthoracic Echocardiography examination for RV systolic Function 24 h before ASD closure, and 6 months after closure. Results: There was a significant decrease in the right ventricle systolic function indices (TAPSE, FAC, Tissue Doppler S wave velocity, and global longitudinal free wall strain) after ASD closure either by surgery or by transcatheter device closure Conclusions: The right ventricle's size and function are affected by a large shunt caused by an ASD secudium. ASD and its consequent volume overload resulted in higher RV myocardial contraction, leading to an increase in strain values and RV systolic function indices, which were reduced and returned to normal values when the left-to-right shunt was eliminated, and the defect was closed.
ABSTRACT
The optimal plane for measurement of the right ventricular (RV) volumes by real-time three-dimensional echocardiography (RT3DE) was determined and the feasibility and accuracy of RT3DE in studying RV systolic function was assessed. RV "Full volume" images were acquired by RT3DE in 22 healthy subjects. RV end-diastolic volumes (RVEDV) and end-systolic volumes (RVESV) were outlined using apical biplane, 4-plane, 8-plane, 16-plane offline separately. RVSV and RVEF were calculated. Meanwhile tricuspid annual systolic excursion (TASE) was measured by M-mode echo. LVSV was outlined by 2-D echo according to the biplane Simpsons rule. The results showed: (1) There was a good correlation between RVSV measured from series planes and LVSV from 2-D echo (r=0.73; r=0.69; r=0.63; r=0.66, P＜0.25-0. 0025); (2) There were significant differences between RVEDV in biplane and those in 4-, 8-, 16-plane (P＜0. 001). There was also difference between RV volume in 4-plane and that in 8-plane (P＜0.05), but there was no significant difference between RV volume in 8-plane and that in 16-plane (P＞0.05); (3) Inter-observers and intro-observers variability analysis showed that there were close agreements and relations for RV volumes (r=0. 986, P＜0. 001; r=0.93, P＜0. 001); (4) There was a significantly positive correlation of TASE to RVSV and RVEF from RT3DE (r=0.83; r=0.90). So RV volume measures with RT3DE are rapid, accurate and reproducible. In view of RVs complex shape,apical 8-plane method is better in clinical use. It may allow early detection of RV systolic function.