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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.

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