Assessment Of Right Ventricular Function In Patients With Atrial Septal Defect By Automated Tissue Motion Tracking Of Tricuspid Annular Displacement

Background:The main path physiological characteristics of atrial septal defect (ASD) is the blood shunting from the left atrium to the right atrium. Due to the long-term left to right shunt, ASD patients often bear decreased right ventricular function, which could trigger a series of clinical syndromes, such as shortness of breath after labour, palpitations, respiratory tract infection, heart failure and so on. The right ventricular has important significance to maintain cardiac output, effective blood volume and overall hemodynamics. So, accurate assessment of the right ventricular function has important clinical value to evaluate of the illness state, alternate treatment programs and judge the prognosis in patients with ASD. At present, real-time three-dimensional echocardiography (RT-3DE) could evaluate the right ventricular systolic function more accurately than other thchnologis, but it has also shot comings of its own, such as the higher image quality requirements, vulnerable to the impact of the acoustic window and breathing exercises, less clear intima than two-dimensional image, and the time-consuming operation, so the RT-3DE can not be used in clinical practic routinely. Tissue motion annular displacement is a new technology based on speck tracking imaging techniques, which was used to assess the right ventricular systolic function by measuring the tricuspid annular displacement. TMAD overcomes the defects of the RT-3DE and could be used in clinical practic routinely.Objective:To explore the clinical value of tricuspid annular displacement measured by tissue motion annular displacement (TMAD) technique in patients with atrial septal defect (ASD).Methods:Thirty-six patients with ASD were enrolled as patient group and twenty-three normal individuals were enrolled as controlled group. The inner diameter of main pulmonary artery (MPA), right atrium (RA), right ventricular (RV) and right ventricular ejection fraction (RVEF) were measured by two-dimensional echocardiography. The TAD of the two groups at right ventricular free wall, septum and the mid-point (recorded as T1, T2, Tm) were measured by TMAD technique and compared.Results:The T1, Tm of the patient group were lower than that of the controlled group [(19.1±4.8)mm vs (22.4±3.0)mm,(15.6±3.7)mm vs (19.0±2.2)mm, respectively, P<0.05]. The T2had no significant difference between the two groups.Conclusion:T1and Tm of the patients were lower significantly than the normal individuals, so TMAD technique may be used to evaluate the right ventricular systolic function in patients with ASD.