Application Of Speckle-tracking Echocardiographic To The Assessment Of Right Ventricular Myocardial Deformation In Adult Patients Before And After Percutaneous Closure Of Atrial Septal Defects

Objective:To evaluate the right ventricular myocardial deformation in patients before and after percutaneous closure of atrial septal defects by Two-dimensional Speckle-tracking echocardiographic(2D-STE),Three-dimensional Speckle-tracking echocardiographic(3D-STE)Methods:To evaluate the change of right ventricular of isolated atrial septal defect(ASD)30 adult patients have been examined by echocardiography,2D-STE,3D-STEbefore and after percutaneous closure of ASD.Twenty normal adult subjects,as control group were included.To observe the changes of global and regional strain(S)of Right Ventricular Free Wall(RVFW),Inter-Ventricular Septum(IVS)in adult patients before and after percutaneous closure of atrial septal defects and normal control.Results:1.RA diameter,RV diameter,TAPSE,TASa,were significantly higher in the patient group.Before and at the third day,first month after closing ASD the RV diameter,RA diameter TAPSE,TASa,PASPwere decreased.2.When comparing S there were no significant differences between the two groups concerning RV lateral basal S and septal S.Only lateral basal,mid S was significantly higher in the patient group.The RV free wall global longitudinal strain(RVFW-GLS)of 3D-STE was higher in the patient group(P<0.05).There was no statistically significant difference between the ASD and the control group in Inter-Ventricular Septum global longitudinal strain(IVS-GLS).(P>0.05).3.Before and After closure mid and apical lateral S significantly reduced.(P<0.05).after closure there was a decline in RVFW-GLS(P<0.05).However,There was no significant difference in IVS-GLS.(P>0.05).4.TAPSE?TASa was positive correlated with RVFWGLS.Conclusions:1.RV free wall longitudinal strain can well reflect the right ventricular systolic function(especially in the middle and apical segments).2.After closure the right ventricular of ASD patients began to retract,The parameters that reflect global and regional systolic function of the right ventricle also decreased.3.3D-STE could provide precise and complete quantitative information on the complex wall motion of the RV by tracking myocardial borders.4.2D and 3D speckle tracking were able to provide quantitative information on global and regional wall motion,which could contribute to the identification of additional pathophysiological information on RV function.