Assessment Of Right Ventricular Function In Patients During Transcatheter Closure Of Atrial Spetal Defect Using Quantitative Tissue Velocity Imaging

Objective To assess the change of the rihgt ventricular function of integral and partlysystole and diastolic before and after transcatheter closure of atrial septal defect (ASD) usingquantitative tissue velocity imaging (QTVI). To study the ASD patients with right ventricularvolume and pressure overload on right ventricular function, as well as changes in right ventricular functionafter transcatheter closure.To provides an accurate, fast and noninvasive method to evaluate theright ventricular function of systolic and diastolic for clinical.Materials and Methods We studied46patients with secondum ASD before and after lDay and3months undergoing transcatheter closure of ASD，and30healthy volunteersmatched with age and sex.The echocardiogragh parameters include：(1) Right ventricular RVand right ventricular outflow tract anteroposterior diameter、right ventricular length andhorizontal diameter、right atrial length and horizontal diameter、main pulmonary artery(MPA), right ventricular end-diastolic volume (RVEDV) and end-sistolic volume (RVESV)、ejection fraction (RVEF). tricuspid early diastolic and(E) late diastolic peak flow veloeity (A)and E/A ratio、Pulmonary valve spectrum blood flow to estimates pulmonary artery systolicpressure(PASP) according to tricuspid regurgitation pressure.(2) velocity of systole (Vs)、earlydiastolic velocity (Ve)、Atrial systolic velocity (Va)and Ve/Va ratio of tricuspid annular sitesand central site of right ventricular free wall and interventricular septum was measured byQTVI.Control ASD group were divided into A group (Ve/Va﹥1)and B group (Ve/Va﹤1)according to Ve/Va ratio. Control group matched with age and number.Comparing andanalysing Vs、Ve、Va and Ve/Va of right ventricular wall integral and partly before and after Atrial septal defect closer.Result (1) Compared with control group,RV and RVOT anteroposterior diameter、RVlength and horizontal diameter、RA length and horizontal diameter、MPA、RVEDV、RVESV、RVEF、 E、 A、 E/A and PASP all significantly increased(P<0.01)and significantlydecreased(P<0.01-0.05) after l Days and3months undergoing transcatheter closure.(2)The Vsof tricuspid annulus cite and the central site of free right ventricular wall of the A grouppatients increased significantly (P<0.01)and significantly decreased (P<0.01)after l Days and3months undergoing transcatheter closure of ASD. compared with control group, Ve、Va areno statistical difference，but they decreased after1day(P<0.01)and increased after3months(P<0.05) of tricuspid annulus cite.Vs both Ve and Va of tricuspid annulus cite and the centralsite of interventricular septum did not change significantly (P>0.05).But Vs decreased after1days(P <0.05) and increased slightly after3months. The Vs of tricuspid annulus cite and thecentral cite of free right ventricular wall and interventricular septum of the B group patientsincreased appreciably(P<0.01)and significantly decreased (P<0.01)after l Days and3months.The Ve and Va of tricuspid annulus cite and the central cite of free right ventricular wallsignificantly increased（P<0.05-0.01)compared with control group and significantly decreasedafter1days and slightly increased after3months. Ve and Va of tricuspid annulus cite andthe central site of interventricular septum are no statistical difference compared with controlgroup (P>0.05)but decreased after1days(P <0.05) and increased slightly after3months. Allcites of the Ve/Va of each group are no significant change before and after undergoingtranscatheter closure of ASD.Conclusion (1)ASD patients Long-term left to right split flow lead to right heart shapechange and right ventricular reconstructed.Abnormal haemodynamics corrected aftertranscatheter closure of ASD and right heart form recovery.(2) With the development of thecourse of the patients with ASD, there are varying degrees of right ventricular systolic anddiastolic high-power status, and systolic function changes in early in diastolic function.(3) The right heart hyperdynamic circulation reduced, and right ventricular systolicfunction improved significantly after transcatheter closure.(4) Right ventricular diastolicvelocity is slightly reduced after1day and recovery after3months.(5) Right ventriculardiastolic function no significant changes. before and after ASD occluder.