| Objective:1. To assess the changes of right ventricular diastolic function by the volume-time curve (VTC) of real time three-dimensional echocardiography (RT-3DE) in patients with atrial septal defect (ASD) before and after percutaneous closure.2. To explore the feasibility and clinical value of volume-time curve in evaluation of the right ventricular diastolic function.Methods:A total of 33 adult secundum ASD patients who underwent percutaneous closure were included. The diameter of the defect was measured before the percutaneous ASD closure by routine transthoracic echocardiography(TTE), and measured the following indexes before and after the percutaneous ASD closure:the inner diameter of right ventricle, the transverse diameter of right atrium, the diameter of major pulmonary artery, the tricuspid regurgitation pressure, the Pulse Wave Doppler parameters of tricuspid valves:E and A, the Tissue Doppler Imaging parameters of anterior tricuspid annulus:e and a, and the E/A, e/a, E/a was calculated respectively before and after the percutaneous ASD closure. By the VTCs of RT-3DE, we calculated the time ratios of right ventricular filling to 1/4,1/3,1/2,3/4 capacity, which were defined as D1/4, D1/3, D1/2 and D3/4, respectively. The 1/3 filling fraction (1/3FF), peak-filling rate (PFR) and the ratio of peak filling rate over end-diastolic volume (PFR/EDV) of right ventricle were calculated at the same time.Results:After the percutaneous ASD closure, the E/A and e assessed by the Doppler methords were lower than the before ones, respectively (all P<0.05), and the e/a and E/e showed no statistical difference when compared to the before ones (all P>0.05). After the percutaneous ASD closure, the D1/4, D1/3 and D1/2 determined by RT-3DE were decreased (all P<0.05), the 1/3FF was increased (P<0.05), the PFR was decreased significantly (P<0.01) and the PFR/EDV was decreased, too (P<0.01), but the D3/4 had no statistical difference when compared to the before one (P>0.05). Before the percutaneous ASD closure, the D1/4ã€D1/3ã€D1/2 all had positive correlation with the E/A and e, the PFR has positive correlation with E/A, and the 1/3FF has negative correlation with E/A and e (all P<0.05).The D1/4 has the highest correlation with e in all of the parameters (r=0.46, P< 0.05).Conclusions:The VTCs of RT-3DE let us obtain the related parameters of right ventricular diastolic function simply and reliably, and provide the important reference information for clinic to assess the right ventricular function before and after the percutaneous closure in patients with ASD accurately. |
