Two-dimensional Strain And Strain Rate Imaging Of The Right Ventricle In Adults Of Atrial Septal Defects

Background:Echocardiographic assessment of regional and global function of the right ventricle (RV) remains difficult because of its complex geometry, irregular shape, thin myocardial wall, and extensive trabeculations. Therefore, several parameters are necessary to evaluate its function fully.Shortcomings of conventional echocardiography can be overcome by Doppler-derived and non-Doppler strain/strain rate (s/SR) imaging. Both can quantifyregional myocardial function and can be applied in congenital heart defects, where the RV is exposed to volume or pressure overload. Quantification of RV function on the basis of s/SR has been conducted successfully in a number of congenital lesions with pressure and volume overload (e.g. tetralogy of Fallot,patients with systemic RV).However, data on RV regional function in the pure volume overload are scarce. Prior studies were focused on RV myocardial velocities and documented higher systolic values in paediatric patients with atrial septal defect (ASD) that returned to normal range after transcatheter closure.Data on the impact of long-lasting RV volume overload on RV regional function in adults are scarce. The aim of the study was to assess the regional RV deformation in the population of adults with uncorrected left-to-right shunt and to establish a potential relationship between the severity of left-to-right shunt and RV regional deformation.Objective:Date on regional right ventricle(RV) deformation and RV regional function are scare. The aim of the study was to access RV regional function in adults of uncorrected atrial septal defect(ASD) by two-dimensional strain and strain rate imaging (also called speckle tracking imaging,STI)Methods:We studied35adults of uncorrected ASD(26F/9M,age41.71±16.17), and20healthy adults (13F/7M,age44.60±12.13) were as the control group. Standard transthoracic echocardiographic examinations and Doppler myocardial imaging examinations were performed using commercially available equipment(IE33,Philips) with a matrix probe S5-1. In apical four-chamber view,live images of ASD group and the control group were saved with five consecutive heart cycles. By QLab Software,we gained dates of two-dimensional strain and strain rate.Results:Two-dimensional strain and strain rate of RV segments differed significantly in the group of patients. Strain in middle lateral and apical lateral of RV were higher(p<0.05), but basal lateral did not differ significantly, only higher in mean diastolic strain, compared with the control group(P=0.012).S train rate in all segments of RV differed significantly, only basal lateral in mean diastolic strain rate was no higher than the control group(p=0.805). Conclusion:Two-dimensional strain and strain rate in adults of uncorrected ASD were higher, and they could be used as an indicator of RV regional function.