Research Of Left Ventricular Twist And Rotation Change Before And After Transcatheter Closure In Patients With Ventricular Septal Defect

Objective:Ventricular septal defect is one of the most common congenital heart disease.However,up to now,with the limitations of research methods and technology,there are still lack of systemic research reports about what effects volume load act on left ventricular twist and rotation.Using speckle tracking technique as the main technique,this research aimed to analyze the characteristics of left ventricular twist and rotation in short axis in normal children,and study about what effects volume load act on left ventricular twist and rotation through patients with ventricular septal defect before and after transcatheter closure,and make an attempt to offer some referential data for clinical use.Methods:The cardic ultrasound images of 58 normal children and 36 patients with VSD(before and 1 week after transcatheter closure)in our hospital were collected and then off-line analysis was used to gain the left ventricular twist and rotational relevent parameters to analyse the characteristics in normal children and compare the differences between normal children and patients with VSD,also the changes of left ventricular twist and rotational relevent parameters in patients with VSD received transcatheter closure before and one week after closure were observed to probe the effects volume load act on left ventricular twist and rotation.Results:Our analysis on twist and rotation characteristics of 58 normal children and 36 patients with VSD before and after transcatheter closure revealed that: Viewing from the apex to the bottom of LV,in base segment the rotational curves first appeared a small counterclockwise rotation(which is positive),then mainly clockwise(which is negative),which is o the contrary in apex segment.Also the rotation curves’ waveform of diferent level cardium in three segements of LV were essencially consistent with the global twist waveform and the rotation angles were significantly related with the global twist angle in the same segement.We also studied the changes of left ventricular twist and rotation and pre-load which revealed that:(1)The left ventricular end diastolic diameter and volume index and stroke volume index in VSD group were greater than that in matched group statistical significantly which were obviously reduced after transcatheter closure.(2)The left ventricular basal rotation angle and its peak and left ventricular golbal twist angle and torison in VSD group were greater than that in matched group statistical significantly which were obviously reduced after transcatheter closure while there was no significe with the apical rotation angle and its peak in two groups.(3)There was no correlation between the twist and rotation parameters and the related indexes in patients with ventricular septal defect before and after transcatheter closure,also there was no correlation between the twist and rotation parameters and the left ventricular ejection fraction both measured by M-mode and real-time three dimentional echocardiography.Conclusions:We concluded that the LV global and local twist and rotation parameters were well regular and related leading them to be used as reliable indexs for clinical evaluation in LV function.The LV global twist and basal rotation were increased in patients with VSD,which were decreased after transcatheter closure.However there was no significantly correlation between LV twist and rotation parameters and LV volume.