Evaluation of Early Changes in Atrial and Ventricular Speckle-Tracking After the Device Closure of Atrial Septal Defects

Document Type : Original Article

Authors

1 Echocardiography Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, IR Iran.

2 Rajaie Cardiovascular, Medical and Research Center, Iran University of Medical Sciences, Tehran, IR Iran.

3 Cardiac Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, IR Iran.

Abstract

Background: The transcatheter device closure of secundum type atrial septal defects (ASDs) has now become the first-line strategy in patients with suitable anatomies. Device closure has remarkable effects on the hemodynamics and function of the heart. Precise diagnosis of these changes is significant in determining patients’ outcomes and prognoses. In the current study, we evaluated volumetric, functional, strain, and strain rate changes in the cardiac chambers following successful device closure.
 
Methods: The present prospective cohort study was conducted on 45 patients eligible for ASD device closure. The patients were evaluated for volumetric, functional, Doppler, strain, and strain rate data regarding the left and right atria and ventricles preprocedurally and 48 hours postprocedurally.
 
Results: Significant changes were found in the left ventricular (LV) end-diastolic volume index (P=0.03), the right ventricular (RV) diameter (P≤0.001), the left atrial (LA) volume index (P=0.05), the right atrial (RA) volume index (P=0.001), and the right and left-sided E/e’ ratio (P=0.001 and P=0.004, respectively). Our findings also showed significant reductions in the strain values of all 3 phases of the RA and the LA and the RV free wall after ASD device closure. The LV global longitudinal strain decreased after the procedure but did not reach statistical significance.
 
Conclusions: The LA, RA and RV strain values showed significant reductions after device closure. The decline in LA function following closure was greater in those with larger ASDs. In adult patients undergoing the procedure, abnormal LA function is a clinically relevant issue demanding pre and postprocedural precautions and treatments. (Iranian Heart Journal 2022; 23(4): 80-87)

Keywords


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