Assessment Of Right Ventricular Volume In Pre-Occlusion And Post-Occlusion For Atrial Septal Defect By Two Dimensional And Real-Time Three-Dimensional Echocardiography

Objective (1)To evaluate the change of global and regional right ventricular (RV) volume in pre-occlusion and post-occlusion for atrial septal defect (ASD) by real-time three-dimensional echocardiography (RT-3DE).(2)To investigate the accuracy of two dimensional echocardiography(2-DE) in measuring RV volume in pre-occlusion and post-occlusion for ASD.Methods A total of 33 patients diagnosed secundum ASD were examined by echocardiography. Atrial speptal defect occlusion (ASDO) were measured in all subject. RV volume were calculated by 2-DE and RT-3DE in pre-occlusion and post-occlusion for ASD respectively. RV volume was measured by 2-DE-related half ellipsoid method, biplane area-length method and simpson.The full volume images were acquired by RT-3DE in all subject, then the global and three-regional(Inflow,Body and Outflow) volume-time curves of RV were acquired by Qlab analysis software. Right ventricular end-diastole volume (RVEDV), Right ventricular end-systolic volume(RVESV) and Right ventricular systolic volume(RVSV) in the global and three-segmental were obtained. The ratio of the three regional volume in global RV volume were calculated. Comparing the value of RVEDV and RVESV by 2-DE with that by RT-3DE, and make the analysis at the same time.Results (1)Comparing with the value of pre-occlusion, the value of RV global, body and outflow RVEDV, RVESV and RVSV were decreased after interventional occlusion (P<0.05), also as to the value of inflow RVEDV、 RVSV. The value of inflow EDV,ESV and SV were bigger than that of body and outflow’s regions in pre-occlusion and post-occlusion (P<0.05), the ratio of the value of inflow EDV、ESV and SV in the global RV volume were also bigger than that of the other two regions. (2) Compared to RT-3DE, among the methods of 2-DE measurement in assessing RV volume,obvious underestimated RVEDV and RVESV in pre-occlusion and post-occlusion were observed by simpson and the half ellipsoid method, and there were statistical significant (P<0.001). Underestimated EDV was measured by biplane area-length method,but there was no significant statistical difference before operation in ESV(P>0.05).Also there were no significant statistical difference in both EDV and ESV after the closure of ASD. (3) Through correlated analysis, the methods of simpson and the half ellipsoid for measuring RV volume by 2DE had good correlation with that by RT-3DE, but the correlation between the method of biplane area-length and RT-3DE was the best.Conclusion RT-3DE is a good technology in evaluating the change of RV global and three-regional volumes in pre-occlusion and post-occlusion for ASD. Among measurement methods of 2-DE, biplane area-length is the best method for quantifying RV volume in pre-occlusion and post-occlusion,which may be used to assess the recovery of RV volume.