Evaluation Of Right Ventricular Systolic Function In Adult Patients With Atrial Septal Defect By Speckle Tracking Imaging

Part I Evaluation of Right Ventricular Regional Systolic Function in Adult Patients with Atrial Septal Defect by Two-dimensional Speckle Tracking ImagingObjective:To explore clinical applicant value of regional systolic function on right ventricle in adult patients with atrial septal defect(ASD) by two-dimensional speckle tracking imaging(2D-STI).Methods:Sixty adult patients with secundum atrial septal defect were enrolled including A group without pulmonary hypertension(n=33),B group with pulmonary hypertension(n=27),twenty eight healthy subjects were enrolled in control group.Using 2D-STI,regional longitudinal strain(S) and strain rate(SR)on right ventricle(RV) were acquired and compared.The correlation between S,SR on basal segment free wall of and pulmonary arterial systolic pressure(PASP) were analyzed.Results:1.Compared with the control group,regional longitudinal strain and strain rate of free wall in A group were increased(p<0.05);strain and strain rate of free wall in B group were decreased compared with A group and control group(p<0.05).2.Compared with the control group,longitudinal strain of ventricular septal basal segment in A group was higher,while B group was lower(p<0.05),middle and apical segments were not statistically significant(p>0.05);Compared with the control group,only longitudinal strain rate of ventricular septal apical segment in ASD was higher(p<0.05).3.PASP was negative correlated with S,SR of free wall basal segment(p<0.05).Conclusions: 1.Using 2D-STI,free wall strain, strain rate of right ventricle can early exactly reflect the change of regional right ventricular systolic function, moreover, basal segment of right ventricular free wall is more sensitive in different pulmonary artery pressure, which may exhibit early damage in right ventricular systolic function. 2. 2D-STI can evaluate right ventricular systolic function, providing an important reference for clinical information. Part II Evaluation of Right Ventricular Global Systolic Function in Adult Patients with Atrial Septal Defect by Three-dimensional Speckle Tracking ImagingObjective:To explore clinical applicant value of global systolic function on right ventricular in adult patients with atrial septal defect(ASD) by three-dimensional speckle tracking imaging(3D-STI).Methods:Consecutive Sixty adult patients with single secundum atrial septal defect who were diagnosed by transthoracic echocardiography in General Hospital of Ningxia Medical University were enrolled,including A group without pulmonary hypertension(PH)(n=33),B group with PH(n=27),twenty eight healthy subjects were enrolled in control group.Global longitudinal strain of right ventricular free wall(RVFW-GLS),global longitudinal strain of ventricular septum(IVS-GLS) were measured by 3D-STI.The date in three groups were compared.Besides,correlation between pulmonary arterial systolic pressure(PASP) and relative parameters were analyzed.Results:1.Compared with the control group,RVFW-GLS in A group was increased(p<0.05);while RVFW-GLS in B group was decreased compared with A group and control group(p<0.05). 2.Compared with the control group,IVS-GLS in A group was subtle higher,however,it is not statistically significant(p>0.05). Compared with A group,IVS-GLS in B group was higher(p<0.05). 3.PASP was negative correlated with RVEF,as well as RVFW-GLS which was especially significant correlation.Meanwhile,PASP was positive correlated with RVEDV,RVESV.Conclusions:1. 3D-STI strain parameters can reflect the global right ventricular systolic function in early stage under the different load conditions,accompanied by the emergence of PH,global right ventricular systolic function was significantly reduced. 2. 3D-STI can evaluate change of right ventricular systolic function in early stage,providing an important reference for clinical information.