| Atrial septal defect (ASD) is one of most common congenital heart disease (CHD). It accounts for 10%~30% of all CHD and is common in women. Long-term left to right shunt in ASD leads to the development of right heart volume overload, secondary pulmonary hypertension, congestive heart failure and atrial arrhythmias. The quantitative evaluation of right ventricular (RV) function has a very important significance in evaluating the patient's conditions, determinating therapeutic methods and assessing the curative effect and prognosis of the patients. However, the quantitative evaluation of RV function is very difficult, for many years, angiography has been the clinical standard for determining RV volume, but due to its invasiveness, its use has been restriction. Recently, compute tomography (CT) and magnetic resonance imaging (MRI) has been validated as an accurate technique for determining RV volume. However, the high cost, long examination time, complex image acquisition technique and immobility of CT and MRI instrumentation limit the extensive use of these techniques in clinical practice. Compared with these techniques,echocardiography has the advantages of lower cost, better portability, high temporal resolution, and allows accurate estimation of heart dimensions. Similar to angrography, two-dimensional echocardiography relies on geometric assumptions for determining ventricular volume. However, the right ventricule has a crescentric shape, with a separate infundibulum and prominent trabeculations, it is difficult to describe the right ventricule by a simple geometric figure and therefore, difficult to assess its function in a conventional two-dimensional echocardiography. Recently, progress has made in accurate assessing RV function with application of echocardiography (three-dimensional echocardiography, myocardial performance index, acoustic quantification) independent of geometric assumptions.It has been proved by numerous clinical studies that the elder the patient is, the worse of the complications in patients with ASD is more common. As before operation was its sigulare therapeutic method, at present, transcatheter closure of ASD has many reports. It corrects anatomic anomaly of heart, decreases left to right shunt and will give rise to affect the RV function.Pulmonary hypertension (PH) is one of the most common complications in patients with CHD, and associates closely with therapeutic method, surgical effectiveness, clinical prognosis. But the mechanism PH due to CHD is not clear. Studies about it needs to gostep further. Objectives(1) To assess the accuracy of three-dimensional echocardiography in the quantitative measurement of RV volume by using excised fresh pig heart model.(2) To evaluate RV volume and function and the its change in patients with ASD after transcatheter closure of ASD by three-dimensional echocardiography(3) To evaluate RV function and the its change in patients with ASD after transcatheter closure of ASD by using Doppler echocardiography to measure RVMPI(4) To research the change and clinical significance of plasma endothelin-1 (ET-1) and atrial natriuretic peptide (AMP) concentrations in patients with congenital heart disease (CHD).Methods(1) In 15 excised fresh pig heart model, three-dimensional echocardiography was used to reconstruct the right ventricular cavity, and compare it with actual volume.(2) Three-dimensional echocardiography was performed in 58 patients with ASD (24 men, 34 women; mean [ ± SD] age 28.91 ± 17.12, range 4 to 67) and 32 sex-matched, age-matched healthy people (control group) (18 men, 14 women; mean [ ± SD] age 24.75 ± 12.00, range 4 to 45)to calculate RVEDV(Right ventricular end-diastolic volume), RVESV(Right ventricular end-systolic volume) and RVEF (Right ventricular ejection fraction). Among patients with ASD, 23 patients( 11 men, 12 women; mean [±SD] age 25.70± 13.31, range 6 to 57) were diagnosed to secundum ASD (the stretched diameters of ASD were from 9...
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