Role of echocardiography in monitoring the outcomes of atrial septal defect closure

Background: Atrial Septal Defect (ASD) is among most common congenital heart diseases. Doppler echocardiography could be a useful method to monitor the outcomes of ASD in children. Objectives: To evaluate the role of echocardiography in monitoring the outcomes of ASD closure in children. Subjects and methods: 31 patients (20 girls, 11 boys) with ASD ostinum secundum. The mean age of patients was 9.19+/-4.58 (2-15 years old). The patients had a mean ASD size of 20.71+/-7.81mm, mean Qp/Qs of 3.04+/-1.37. All of them underwent the ASD closure (slow physical development and/or Right Ventricular [RV] enlargement by echo cardiography). They were followed up at 1 week, 1 month, 3 months and 6 months after the closure procedure. Results: All of the patients had improvement in weight. The right ventricular end-diastolic dimension and pulmonary artery diameter decreased significantly (p<0.0001) and normalised at 6 months after ASD closure. There were no trivial shunts. Conclusions: Echocardiography is a helpful noninvasive method to assess the outcomes of ASD closure in children less than 15 years old. ASD closure should be done as soon as possible in children. The procedure resulted in normalization of RV size that was associated with improvement in physical development of children.

Estimation of left ventricular function in ventricular septal defect by tei index

Background: Ventricular Septal Defect (VSD) is one of the most common congenital cardiac diseases, accounting for 20%, and affects the left ventricular function. There is no study on the application of Tei index to evaluate left ventricular function in patients with VSD in Vietnam. Objective:To assess left ventricular function in ventricular septal defect by Tei index. Subject and Method: A cross-sectional descriptive study that involves 35 patients of VSD with an average age of 15.77+/-10.41 (A group: 19 patients of VSD with systolic pulmonary artery pressure (PAPs) < 40 mmHg and B group: 16 patients of VSD with PAPs>=40mmHg and control group: 30 normal volunteers). Results: Tei index for estimation of left ventricular function is higher in the VSD (0.50+/- 0.18) than the control (0.37 +/- 0.03) with p < 0.01, exponentially more in the VSD with PAPs >=40mmHg (0.64 +/- 0.15; p<0.01). Conclusion: Left ventricular function is worse in VSD patients in comparison to the healthy people.

Closure of atrial septal defect in adult over 40 years of age: immediate and follow - up results

Background: Atrial Septal Defect (ASD) is a common congenital cardiac disease, accounting for 10% of congenital heart diseases and 1/3 congenital heart defect in adults. Closure of ASD is often used as a treatment method. However, there is controversial opinions about ASD closure in adult >=40. Objective: To study the outcomes of ASD closure of in adults >= 40 years. Subject and Method: 40 patients (27 female and 13 male) of ASD ostium secundum with an age average of 48.85 +/-5.91 (40 \u2013 62 years) and the mean ASD sizeof 27.53 +/-8.37 mm, mean Qp/Qs of 2.97 +/-1.59 had indications for ASD closure (clinically symptomatic and/or right ventricular [RV] enlargement by echocardiography). Follow-up at 1 week, 1 month, 3 months, 6 months after ASD closure. Results: Left ventricular systolic function was unaffected by ASD closure and the majority of the patients reported improvement in their symptoms. The right ventricle end-diastolic dimension and pulmonary artery diameter decreased significantly (p<0,0001). No trivial shunts. Conclusion: ASD closure is safe and effective in patient over 40 years of age with minimal complications. The procedure resulted in a decrease in the RV size that was accompanied by improvement in clinical symptoms.

Mitral regurgitation after percutaneous valvuloplasty by the INOUE technique for mitral stenosis

Background: Mitral Regurgitation (MR) is a severe complication after percutaneous valvulopalsty for Mitral Stenosis (MS). Objective: To study some predictors, mechanisms and outcome of MR immediately and 3 months after percutaneous valvuloplasty (PMV) by the Inoue technique for mitral stenosis.Subjects and method: 43 patients with MS were followed up for 3 months after PMV by the Inoue technique in the Viet Nam National Heart Institute at Bach Mai Hospital between Jan 2007 to Oct 2007. Results: Uneven mitral leaflets and calcium commissures with Padial\u2019s criteria scoring over 10 was a significant predicator of influence of severe MR after PMV.According to Wilkins\u2019 score, only the calcium commissures affected the MR after PMV (p<0.05). Conclusion: Patients with aortic regurgitation and/or mild MR who\u2019s Wilkins\u2019 scores less than 8 and Padial's scores less than 10 had not be influenced by severe MR after PMV.

Impact of slow pathway ablation on AV conduction in atrioventricular nodal reentrant tachycardia

Introduction: Atrioventricular nodal reentrant tachycardia is quite common in clinical. The use of radiofrequency for this condition is more common. However, there are few studies on the impact of slow pathway ablation on AV conduction.Objectives: To investigate the impact of slow pathway ablation on AV conduction in atrioventricular nodal reentrant tachycardia. Subjects and method: Between Jul 2003 to Jul 2006, 27 patients with typical atrioventricular nodal reentrant tachycardia underwent the slow pathway eradication using radiofrequency. Some AV conduction measurements before and after ablation were compared. Results: There is a significant difference in sinus interval before and after ablation (745.81 +/- 136.63ms vs. 634.61+/-148.82ms, p<0.05). The differences in PA interval (32.03+/-8.71ms vs. 34.15+/-9.36ms), AH interval (67.72+/-18.66ms vs. 69.31+/-25.92ms), Wenckebach AV nodal block (316.32+/-52.13ms vs. 338.16+/-65.52ms), 2:1 AV block (245.95+/-78.46ms vs. 251.62+/-65.31ms) were all not significant. . The fast pathway refractory periods before and after ablation was 358.31+/-68.67ms and 362.48+/-92.11ms, respectively. Conclusion: The slow pathway eradication by radiofrequency for atrioventricular nodal reentrant tachycardia has no impact on the AV conduction.

Role of electrocardiography in evaluation of left ventricular hypertrophy

Background: Echocardiography has provided the most valuable means in detecting Left Ventricular Hypertrophy (LVH), but electrocardiography (ECG) has a greater advantage due to its mobility, simplicity, and low cost. Objective: (1) To examine the sensitivity and specificity of electrocardiographic criteria for LVH and determinants. (2) To study the risk factors affected to sensitivity and specificity of electrocardiography. Subjects and method: ECG and echocardiography were performed in 374 adults. The Romhilt-Estes score was used to measure electrocardiographic LVH, whereas the Framingham criteria of the left ventricular mass index were used to detect LVH on echocardiography. Results: Using echocardiography as a gold standard, sensitivity of ECG was 35.8%, specificity was 90.3%. The overall probability of correct diagnosis was 82.6%. Older people and men had tended to increase the value of ECG in detecting LVH. Conclusion: The high specificity but low sensitivity suggested an adjusted ECG criterion for a better diagnosis of electrocardiographic LVH.

Left ventricular dimensions and systolic function by echocardiography before and after atrial septal defect closure

Background: Atrial Septal Defect (ASD) is one of the most common congenital cardiac defects. Both surgical and catheter occlusion of the defect has been found effective and safe in eliminating interatrial shunting. However, knowledge of the response of the left side of the heart to ASD closure is incomplete. Objective: This study assessed the left side of the heart\u2019s response to ASD closure over a 6-month follow-up period. Subjects and method: 148 patients of ASD ostium secundum with an average age of 26.13 +/- 14.24 years (2-62 years) and the mean ASD size of 24.92 +/- 7.97 mm has been studied by echocardiography before and after atrial septal defect closure. Results: The right ventricular diameter and hemodynamics were improved after ASD closure (p<0.0001). The left ventricular end-diastolic diameter and volume increased significantly after ASD closure (p<0.0001). Conclusions: The left ventricular systolic function was unaffected by ASD closure. The right side of the heart\u2019s response to ASD closure over 6-month follow-up period decreased significantly (p<0.0001).

Evaluation of electrocardiographic left ventricular hypertrophy in community

Background: Left Ventricular Hypertrophy (LVH) has been shown to be a risk factor as well as a consequence of cardiovascular diseases. The importance of an early LVH diagnosis in the community has been desmontrated by many case studies. Objectives: (1) Find out the prevalence of electrocardiographic LVH. (2) Determine the risk factors of electrocardiographic LVH. Subjects and method: 3561 people (1410 men) over 25 years old were chosen from 3 provinces/cities (Ha Noi, Thai Binh, and Nghe An). All participants underwent electrocardiogram, and the Romhilt-Estes score on standard 12-lead electrocardiogram to measure LVH. Diagnosis of LVH was made when Romhilt-Estes score >=4. Data was analyzed by Epi-Info software version 6.04 and SPSS version 13.0. Results: According to JNC 7, there were 744 people with hypertension (352 men), accounted for 21.2%. The rate of hypertension was 24.9% in men and 18.2% in women. This difference was statistically significant (p <0.001). Overall prevalence of electrocardiographic LVH was 6.71% (95% CI: 5.94 \u2013 7.58%). Prevalence was 9.00% among men (95% CI: 7.62 \u2013 10.61%) and 5.21% in women (95% CI: 4.35 \u2013 6.23%). Risk factors of electrocardiographic LVH included male, elderly, hypertension, and obesity. Conclusion: The high prevalence of LVH in the population showed the importance of detection and early treatment for LVH patients, especially in those, who had no clinical symptoms.