Evaluation Of Changes Of Left Ventricular Systolic Function After Transchateter Closure Of Ventricular Septal Defect Using Velocity Vector Imaging

Objective:To investigate the left ventricular systolic function in patients with ventricular septal defect(VSD) after transcatheter closure by velocity vector imaging(VVI).Methods:20 healthy volunteers(8 men,12 women; average age 9.3±5.2 years) and 32 patients with VSD(13 men,19 women; average age 8.1±4.7 years) before closure and in 3rd day(3d),1st month(1m),3rd month(3m) and 6th month(6m) after closure experienced transthoracic echocardiography(TTE) and VVI examinations. Standard echocardiography with VVI studies was performed on a Siemens Sequoia 512 echocardiography scanner with a 2.25-4.25 MHz cardiac transducer. The frame rate was kept between 70 and 100 Hz. Left ventricular ejection fraction(LVEF) and fractional shortening (LVFS) were measured by TTE. Longitudinal peak systolic strain (LPSS) and radial peak systolic strain (RPSS) of all segments of left ventricle were measured in three standard apical views and three short views by VVI. Compare these four parameters among 5 groups of VSD patients. Compare LPSS and RPSS between VSD patients in 6m after closure and healthy volunteers.Results:1,LVEF and LVFS of VSD patients before and after closure were all normal,and there were no differences among these 5 groups (P>0.05)2,Except the posterior and inferior walls at baseline and posterior wall at middle segments, LPSS of the other segments of left ventricle of VSD patients in lm,3m and 6m after closure were lower than pre-operation and in 3d after closure (P<0.05); while there were no differences between in 3d after closure and pre-operation (P> 0.05),no differences were found among in lm,3m and 6m after closure (P>0.05)3,Except the anteroseptal at the level of mitral ring and lateral wall at the level of papillary muscle, RPSS of the other segments of these two levels of left ventricle of VSD patients in lm,3m and 6m after closure were lower than pre-operation and in 3d after closure (P<0.05); while there were no differences between in 3d after closure and pre-operation (P>0.05),no differences were found among in lm,3m and 6m after closure (P>0.05)4,RPSS of lateral and inferior walls at the level of apex of left ventricle of VSD patients in 6m after closure were higher than pre-operation and in 3d,lm and 3m after closure (P<0.05), RPSS of anterior and septal walls at the level of apex in 3m and 6m after closure were higher than pre-operation and in 3d,lm after closure(P<0.05); there were no differences among pre-operation and in 3d,lm after closure in all segments (P>0.05)5,No differences of LPSS and RPSS of all segments of left ventricle were found between VSD patients in 6m after closure and healthy volunteers (P>0.05)Conclusion:1,The abnormal hemodynamics was corrected after VSD occlusion, and transcatheter closure of VSD can improve left ventricular systolic function at the same time.2,VVI could detect the movement information of longitudinal and radial myocardial fiber, provide an accurate approach to assess the left ventricular systolic function of VSD patients after closure.