Iranian Heart Journal

Iranian Heart Journal

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

Document Type : Original Article

Authors
Niloufar Samiei 1
Raheleh Kaviani 1
sedighe saedi 2
Zahra Khajali 2
Ata Firouzi 3
Behshid Ghadrdoost 2
Mehrnoosh Ebrahimi 1
Tahereh Saedi 2
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
Atrial septal defect
Device closure
Speckle-tracking
Strain and strain rate
  1. Suzuki K, Kato T, Koyama S, Shinohara T, Inukai S, Sato J, Yamamoto H, Omori D, Yoshida S, Takeda S, Nishikawa H. Influence of Percutaneous Occlusion of atrial septal defect on left atrial function evaluated using 2D Speckle-tracking echocardiography. International heart journal. 2020:19-73.
  2. Fraisse A, Latchman M, Sharma SR, Bayburt S, Amedro P, Di Salvo G, Baruteau AE. Atrial septal defect closure: indications and contra-indications. Journal of thoracic disease. 2018 Sep; 10(Suppl 24):S2874.
  3. Jin X, Hummel YM, Tay WT, Nauta JF, Bamadhaj NS, van Melle JP, Lam CS, Voors AA, Hoendermis ES. Short-and long-term haemodynamic consequences of transcatheter closure of atrial septal defect and patent foramen ovale. Netherlands Heart Journal. 2021 Feb 16:1-7.
  4. Sareban M, Perz T, Macholz F, Reich B, Schmidt P, Fried S, Mairbäurl H, Berger MM, Niebauer J. Reliability of echocardiographic speckle-tracking derived bi-atrial strain assessment under different hemodynamic conditions. The international journal of cardiovascular imaging. 2017 Nov; 33(11):1685-92.
  5. Badano LP, Kolias TJ, Muraru D, Abraham TP, Aurigemma G, Edvardsen T, D’Hooge J, Donal E, Fraser AG, Marwick T, Mertens L. Standardization of left atrial, right ventricular, and right atrial deformation imaging using two-dimensional Speckle-tracking echocardiography: a consensus document of the EACVI/ASE/Industry Task Force to standardize deformation imaging. European Heart Journal-Cardiovascular Imaging. 2018 Jun 1; 19(6):591-600.
  6. Hajizeinali A, Iri M, Hosseinsabet A. Assessment of the Right and Left Atrial Functions at Midterm After Surgical and Device Atrial Septal Defect Closure: A 2‐Dimensional Speckle‐Tracking Echocardiographic Study. Journal of Ultrasound in Medicine. 2019 Aug; 38(8):1979-93.
  7. Kumar P, Sarkar A, Kar SK. Assessment of ventricular function in patients of atrial septal defect by strain imaging before and after correction. Annals of cardiac anaesthesia. 2019 Jan; 22(1):41.
  8. Aslan M, Erturk M, Turen S, Uzun F, Surgit O, Ozbay Ozyilmaz S, Rifat Yildirim M, Faruk Baycan O, Uygur B, Yildirim A, Eksik A. Effects of percutaneous closure of atrial septal defect on left atrial mechanical and conduction functions. European Heart Journal–Cardiovascular Imaging. 2014 Oct 1; 15(10):1117-24.
  9. Pathan F, D'Elia N, Nolan MT, Marwick TH, Negishi K. Normal ranges of left atrial strain by speckle-tracking echocardiography: a systematic review and meta-analysis. Journal of the American Society of Echocardiography. 2017 Jan 1; 30(1):59-70.
  10. Padeletti M, Cameli M, Lisi M, Malandrino A, Zacà V, Mondillo S. Reference values of right atrial longitudinal strain imaging by two‐dimensional Speckle-tracking. Echocardiography. 2012 Feb; 29(2):147-52.
  11. Park JH, Choi JO, Park SW, Cho GY, Oh JK, Lee JH, Seong IW. Normal references of right ventricular strain values by two-dimensional strain echocardiography according to the age and gender. The international journal of cardiovascular imaging. 2018 Feb; 34(2):177-83.
  12. Sugimoto T, Dulgheru R, Bernard A, Ilardi F, Contu L, Addetia K, Caballero L, Akhaladze N, Athanassopoulos GD, Barone D, Baroni M. Echocardiographic reference ranges for normal left ventricular 2D strain: results from the EACVI NORRE study. European Heart Journal-Cardiovascular Imaging. 2017 Aug 1; 18(8):833-40.
  13. Cakal S, Eroglu E, Baydar O, Cakal B, Yazicioglu MV, Bulut M, Dundar C, Tigen K, Ozkan B, Acar G, Avci A. Two‐dimensional strain and strain rate imaging of the left atrium and left ventricle in adult patients with atrial septal defects before and after the later stage of percutaneous device closure. Echocardiography. 2015 Mar; 32(3):470-4.
  14. Reddy YN, Obokata M, Egbe A, Yang JH, Pislaru S, Lin G, Carter R, Borlaug BA. Left atrial strain and compliance in the diagnostic evaluation of heart failure with preserved ejection fraction. European journal of heart failure. 2019 Jul; 21(7):891-900.
  15. Di Salvo G, Drago M, Pacileo G, Rea A, Carrozza M, Santoro G, Bigazzi MC, Caso P, Russo MG, Carminati M. Atrial function after surgical and percutaneous closure of atrial septal defect: a strain rate imaging study. Journal of the American Society of Echocardiography. 2005 Sep 1; 18(9):930-3.
  16. Alkhateeb A, Roushdy A, Hasan-Ali H, Kishk YT, Hassan AK. The changes in biventricular remodelling and function after atrial septal defect device closure and its relation to age of closure. The Egyptian Heart Journal. 2020 Dec; 72(1):1-0.
  17. Ozturk O, Ozturk U, Ozturk S. Assessment of right atrial function with Speckle-tracking echocardiography after percutaneous closure of an atrial septal defect. Revista Portuguesa de Cardiologia (English Edition). 2017 Dec 1; 36(12):895-900.
Iranian Heart Journal
Volume 23, Issue 4
Autumn 2022
Pages 80-87