Segmental Analysis of Right Ventricular Longitudinal Deformation in Children before and after Percutaneous Closure of Atrial Septal Defect
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Background: The aim of study is to identify the dependence of right ventricular (RV) free wall longitudinal deformation onventricular loading through segmental approach in relatively large number of patients with atrial septal defect (ASD). Methods: Patients with ASD (n = 114) and age matched healthy children (n = 60) were echocardiographically examined theday before percutaneous device closure and within 24 hours afterwards. RV free wall deformation parameters, strain (є) and strainrate (SR), were analyzed in the apical (єA, SRA) and basal (єB, SRB) segments. Measured deformation parameters were adjusted forRV size (єAL, SRAL, єBL, SRBL) by multiplying by body surface area indexed RV longitudinal dimension. Regression analysesdetermined the relationships of these deformation parameters with RV loading parameters that were measured by catheterization. Results: єBL and SRBL were not different between pre-closure patients and controls (p = 0.245, p = 0.866), and were decreasedpost-closure (p = 0.001, p = 0.018). Post-closure єBL was lower than in controls (p = 0.001). Pre-closure єAL and SRAL were higherthan in controls (p = 0.001, p < 0.001), but decreased after closure (all p < 0.001). The pulmonary to systemic flow ratio wasrelated to procedural differences of єBL (p = 0.017) and of SRBL (p = 0.019). RV end diastolic pressure was negatively related topost-closure єBL (p = 0.020) and post-closure SRBL (p = 0.012), and the procedural SRBL difference (p = 0.027). Conclusion: The longitudinal deformation of the RV basal segment is dependent and its remodeling is also dependent onvolume loading in children with ASD.
Abstract
Background: The aim of study is to identify the dependence of right ventricular (RV) free wall longitudinal deformation onventricular loading through segmental approach in relatively large number of patients with atrial septal defect (ASD). Methods: Patients with ASD (n = 114) and age matched healthy children (n = 60) were echocardiographically examined theday before percutaneous device closure and within 24 hours afterwards. RV free wall deformation parameters, strain (є) and strainrate (SR), were analyzed in the apical (єA, SRA) and basal (єB, SRB) segments. Measured deformation parameters were adjusted forRV size (єAL, SRAL, єBL, SRBL) by multiplying by body surface area indexed RV longitudinal dimension. Regression analysesdetermined the relationships of these deformation parameters with RV loading parameters that were measured by catheterization. Results: єBL and SRBL were not different between pre-closure patients and controls (p = 0.245, p = 0.866), and were decreasedpost-closure (p = 0.001, p = 0.018). Post-closure єBL was lower than in controls (p = 0.001). Pre-closure єAL and SRAL were higherthan in controls (p = 0.001, p < 0.001), but decreased after closure (all p < 0.001). The pulmonary to systemic flow ratio wasrelated to procedural differences of єBL (p = 0.017) and of SRBL (p = 0.019). RV end diastolic pressure was negatively related topost-closure єBL (p = 0.020) and post-closure SRBL (p = 0.012), and the procedural SRBL difference (p = 0.027). Conclusion: The longitudinal deformation of the RV basal segment is dependent and its remodeling is also dependent onvolume loading in children with ASD.
참고문헌 (25)
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