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Impact of atrial septal defect device size on biventricular global and regional function: a two-dimensional strain echocardiographic study

Part of: Advanced Imaging

Published online by Cambridge University Press:  05 August 2021

Areej Alkhateeb Open the ORCID record for Areej Alkhateeb [Opens in a new window] ,
Alaa Roushdy ,
Hosam Hasan-Ali ,
Yehia T. Kishk ,
Aya El Sayegh  and
Ayman K.M. Hassan
Areej Alkhateeb*
Affiliation:
Cardiology Division of Internal Medicine Department, South Valley University Hospital, Qena, 83523Egypt
Alaa Roushdy
Affiliation:
Congenital and Structural Heart Disease Unit, Cardiology Department – Ain Shams University Hospitals, Cairo, 11566Egypt
Hosam Hasan-Ali
Affiliation:
Department of Cardiology, Assiut University Hospitals, Assiut, 71515Egypt
Yehia T. Kishk
Affiliation:
Department of Cardiology, Assiut University Hospitals, Assiut, 71515Egypt
Aya El Sayegh
Affiliation:
Congenital and Structural Heart Disease Unit, Cardiology Department – Ain Shams University Hospitals, Cairo, 11566Egypt
Ayman K.M. Hassan
Affiliation:
Department of Cardiology, Assiut University Hospitals, Assiut, 71515Egypt
*
Author for correspondence: Areej A.A.Tammam Alkhateeb, CVR Msc (KCL, UK), MD, PhD, Cardiology Division of Internal Medicine Department, South Valley University Hospital, 83523Qena, Egypt. Mobile: (+20) 1023858689. E-mail: [email protected]
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Abstract

Objective:

In this study, we assessed the acute changes in biventricular longitudinal strain after atrial septal defect transcatheter closure and its relation to the device size.

Methods:

Hundred atrial septal defect patients and 40 age-matched controls were included. Echocardiography and strain study were performed at baseline and 24 hours and 1 month after the intervention. The study group was divided into two subgroups; group 1: smaller devices were used (mean device size = 1.61 ± 0.05 cm, n = 74) and group 2: larger devices were used (mean device size = 2.95 ± 0.07 cm, n = 26).

Results:

At baseline, there was a significant difference between the study group and controls as regards right ventricular global longitudinal strain with significant hyperkinetic apex (p = 0.033, p = 0.020, respectively). There was a significant immediate reduction in right ventricular global longitudinal strain (from −24.43 ± 0.49% to −21.62 ± 0.47%, p < 0.001), which showed insignificant improvement after 1-month follow-up. While only left ventricular global longitudinal strain increased after 1 month. Within 24 hours of device closure, all the basal- and mid-lateral segments strains and apical right ventricular strains showed a significant reduction. There was a significant negative correlation between the indexed large device size and an immediate change in the right ventricular global longitudinal strain (r = −0.425, p = 0.034).

Conclusion:

Significant right ventricular global longitudinal strain reduction starts as early as 24 hours after transcatheter closure, irrespective of the device size used. The rapid impact of closure was mainly on the biventricular basal and lateral segments and right ventricular apical ones, especially with the large sized atrial septal defect.

Keywords

Atrial septal defecttranscatheter closure devicestrain
Type
Original Article
Information
Cardiology in the Young , Volume 32 , Issue 5 , May 2022 , pp. 746 - 754
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Copyright
© The Author(s), 2021. Published by Cambridge University Press

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Footnotes

All authors contribute to the work equally.

References

Wu, ET, Akagi, T., Taniguchi, M., et al. Differences in right and left ventricular remodeling after transcatheter closure of atrial septal defect among adults. Catheter Cardiovasc Interv 2007; 69: 866–71.CrossRefGoogle ScholarPubMed
Buckberg, GD, Weisfeldt, ML, Ballester, M, et al. Left ventricular form and function: scientific priorities and strategic planning for development of new views of disease. Circulation 2004; 110: e333–6.CrossRefGoogle ScholarPubMed
Jategaonkar, S, Scholtz, W, Schmidt, H, et al. Percutaneous closure of atrial septal defects: echocardiographic and functional results in patients older than 60 years. Circ Cardiovasc Interv 2009; 2: 85–9.CrossRefGoogle ScholarPubMed
Di Salvo, G, Drago, M, Pacileo, G, et al. Comparison of strain rate imaging for quantitative evaluation of regional left and right ventricular function after surgical versus percutaneous closure of atrial septal defect. Am J Cardiol 2005; 96: 299–302.CrossRefGoogle ScholarPubMed
McConnell, MV, Solomon, SD, Rayan, ME, et al. Regional right ventricular dysfunction detected by echocardiography in acute pulmonary embolism. Am J Cardiol 1996; 78: 469–73.CrossRefGoogle ScholarPubMed
Van De Bruaene, A, Buys, R, Vanhees, L, et al. Regional right ventricular deformation in patients with open and closed atrial septal defect. Eur J Echocardiogr 2011; 12: 206–13.CrossRefGoogle ScholarPubMed
Eroglu, E, Cakal, SD, Cakal, B, et al. Time course of right ventricular remodeling after percutaneous atrial septal defect closure: assessment of regional deformation properties with two-dimensional strain and strain rate imaging. Echocardiography 2013; 30: 324–30.CrossRefGoogle ScholarPubMed
Stout, KK, Daniels, CJ, Aboulhosn, JA, et al. 2018 AHA/ACC Guideline for the Management of Adults With Congenital Heart Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation 2019; 139: e698–e800.Google Scholar
Cardiology, E.b.t.A.f.E.P., A.T.F. Members, Baumgartner, H, et al. ESC Guidelines for the management of grown-up congenital heart disease (new version 2010): the Task Force on the Management of Grown-up Congenital Heart Disease of the European Society of Cardiology (ESC). Eur Heart J 2010; 31: 2915–2957.Google Scholar
Silvestry, FE, Cohen, MS, Armsby, LB, et al. Guidelines for the Echocardiographic Assessment of Atrial Septal Defect and Patent Foramen Ovale: From the American Society of Echocardiography and Society for Cardiac Angiography and Interventions. J Am Soc Echocardiogr 2015; 28: 910–958.CrossRefGoogle ScholarPubMed
Baumgartner, H, Bonhoeffer, P, De Groot, NMS, et al. ESC Guidelines for the management of grown-up congenital heart disease (new version 2010). Eur Heart J 2010; 31: 2915–2957.Google Scholar
Silversides, CK, Dore, A, Poirier, N, et al. Canadian Cardiovascular Society 2009 Consensus Conference on the management of adults with congenital heart disease: shunt lesions. Can J Cardiol 2010; 26: e70–e79.CrossRefGoogle Scholar
Voigt, JU, Pedrizzetti, G, Lysyansky, P, et al. Definitions for a common standard for 2D speckle tracking echocardiography: consensus document of the EACVI/ASE/Industry Task Force to standardize deformation imaging. Eur Heart J Cardiovasc Imaging 2015; 16: 1–11.CrossRefGoogle ScholarPubMed
Meyer, MR, Kurz, DJ, Bernheim, AM, et al. Efficacy and safety of transcatheter closure in adults with large or small atrial septal defects. SpringerPlus 2016; 5: 1841–1841.CrossRefGoogle ScholarPubMed
Romanelli, G, Harper, RW, Mottram, PM. Transcatheter Closure of Secundum Atrial Septal Defects: Results in Patients with Large and Extreme Defects. Heart Lung Circ 2014; 23: 127–131.CrossRefGoogle ScholarPubMed
Voigt, J-U, Cvijic, M. 2- and 3-Dimensional Myocardial Strain in Cardiac Health and Disease. JACC: Cardiovasc Imaging 2019; 12: 1849–1863.Google ScholarPubMed
İslamlı, A, Cümşüdov, K, Bilgin, M, et al. Transcatheter Closure of Atrial Septal Defect and the Effects on Right Ventricular Function; Strain and Strain Rate Echocardiography. J Am Coll Cardiol 2013; 62: C175–C176.CrossRefGoogle Scholar
Bussadori, C, Oliveira, P, Arcidiacono, C, et al. Right and left ventricular strain and strain rate in young adults before and after percutaneous atrial septal defect closure. Echocardiography 2011; 28: 730–7.CrossRefGoogle ScholarPubMed
Van De Bruaene, A, Buys, R, Vanhees, L, et al. Regional right ventricular deformation in patients with open and closed atrial septal defect. Eur J Echocardiogr 2010; 12: 206–13.CrossRefGoogle ScholarPubMed
Xu, Q, Sun, L, Zhou, W, et al. Evaluation of right ventricular myocardial strains by speckle tracking echocardiography after percutaneous device closure of atrial septal defects in children. Echocardiography 2018; 35: 1183–1188.CrossRefGoogle ScholarPubMed