Assessment Of Right Ventricular Long-axis Function In Patients During Transcatheter Closure Of Atrial Septal Defect Using Tissue Doppler Imaging

Objection To assess the change of the right ventricular long-axis function before and after transcatheter closure of atrial septal defect (ASD) and to discuss its clinical value. Methods We studied 34 patients with secundum ASD before and after 1 week and 3 months undergoing transcatheter closure of ASD, and 32 healthy volunteers matched with age and sex. The right ventricular end-diastolic diameter (RV), ratio of right to left ventricular end-diastolic diameter (RV/LV) and ratio of right to left atrial end-diastolic diameter (RA/LA) were measured and calculated in the apical four chamber view and main pulmonary artery diameter (MPA) was measured in the parasternal short axis view by transthoracic two-dimensional echocardiography. From the apical four chamber view, pulsed wave Doppler was applied to obtained the image of tricuspid, mitral inflow and tricuspid regurgitation, early diastolic peak flow velocity (E), late diastolic peak flow velocity (A), E/A ratio, deceleration time of E wave (E_DT) and peak velocity of tricuspid regurgitation were measured. Using tissue Doppler imaging (TDI), the lateral tricuspid annular systolic peak velocity (S_M), the systolic excursion (D_S), the pre-contraction time (PCT_M), contraction time (CT_M), PCT_M/CT_M ratio, early diastolic myocardial motion velocity (E_M), late diastolic peak myocardial motion velocity (Am) and the ratio of E_M/A_M were measured. Results RV, RV/LV, RA/LA, MPA, E, A and E_DT of tricuspid inflow imaging were significantly different between patients with ASD and normal controls. Comparing to normal controls, S_M and D_S in patients were significantly increased (17.86±3.25cm/s, 2.67±0.36cm vs 13.89±1.40cm/s, 2.37±0.22cm, P<0.001), PCT_M, CT_M were significantly shorter (83±28 ms, 261±23ms vs 94±21ms, 284±19 ms, P <0.01) than in the control group; E_M, A_M was significantly increased (17.6±3.6cm/s, 13.6±3.7cm/s vs 14.23±2.03cm/s, 11.70±2.6cm/s, P<0.001), There was no differences in E_M/A_M ratio and PCT_M/CT_M ratio between the ASD and control group. Followed by the increase of pulmonary artery systolic pressure, S_M, D_S decreased gradually, PCT_M/CT_M ratio increased gradually, E_M, E_M/A_M ratio decreased gradually. Linear correlation analysis showed there was excellent correlation between pulmonary artery systolic...