Echocardiographic Evaluation of Changes in Cardiac Hemodynamics, Loading Conditions, and Atrial Function after Transcatheter Closure of Atrial Septal Defect

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Mohamed Abdelfattah Shoeir ◽  
Ghada Elshahed ◽  
Yasmin Abdelrazek Esmail ◽  
Dina Adel Ezz Eldin
Keyword(s):  
Atrial Septal Defect ◽  
Strain Rate ◽  
Septal Defect ◽  
Atrial Function ◽  
Loading Conditions ◽  
Systolic Strain ◽  
Peak Systolic Strain ◽  
Strain And Strain Rate ◽  
Significant Difference ◽  
Asd Closure

Abstract Background The changes in loading conditions, atrial function, and the different echocardiographic parameters before and after transcatheter atrial septal defect (ASD) closure are still under study. So we felt the need to evaluate the echocardiographic changes that occur and detect the timing after closure at which the right-sided heart hemodynamics, and measurements are back to normal. Objectives To evaluate the changes in cardiac hemodynamics, loading conditions, and atrial function after percutaneous closure of ASD using echocardiography. Patients and Methods The study included 30 patients referred to percutaneous closure of ASD in Ain Shams University hospital we performed echocardiography before, 1 week, and 3 months after closure. Results The study showed that RV dimensions and volumes decreased significantly 1 week, and 3 months after ASD closure (p < 0.001). RA dimensions and volumes decreased significantly 1 week, and 3 months after ASD closure (p < 0.001). RA peak systolic strain, and strain rate increased significantly 1 week, and 3 months after ASD closure (p < 0.001). LA dimensions and volumes increased significantly 1 week, and 3 months after ASD closure (P < 0.001). LA peak systolic strain showed no significant difference before, 1week, and 3 months after ASD closure (P = 0.063), and strain rate showed no significant difference before, 1week, and 3 months after ASD closure (P = 0.207). Conclusion In our study, we have concluded that RV dimensions and volumes decreased significantly 1 week, and 3 months after ASD closure. RA dimensions and volumes decreased significantly 1 week, and 3 months after ASD closure. RA peak systolic strain, and strain rate increased significantly 1 week, and 3 months after ASD closure, as a result of improvement of the RA wall velocity, due to relief of the volume overload after closure of the shunt. LA peak systolic strain, and strain rate showed no significant difference before, 1week, and 3 months after ASD closure. Abbreviations list ASD (atrial septal defect), RV (right ventricle), RA (right atrium), LA (left atrium).

scholarly journals Left Atrial Strain to Identify Diastolic Dysfunction in Children with Cardiomyopathies

2019 ◽  
Vol 8 (8) ◽  
pp. 1243 ◽  
Author(s):  
Jolanda Sabatino ◽  
Giovanni Di Salvo ◽  
Costantina Prota ◽  
Valentina Bucciarelli ◽  
Manjit Josen ◽  
...  
Keyword(s):  
Strain Rate ◽  
Diastolic Dysfunction ◽  
Left Atrial ◽  
Left Ventricular ◽  
Systolic Strain ◽  
Operating Characteristics ◽  
Left Atrial Strain ◽  
Peak Systolic Strain ◽  
Strain And Strain Rate ◽  
Significant Difference

Background: Left ventricular (LV) diastolic dysfunction (DD) carries worse prognosis in childhood. 2-dimensional (2-D) left atrial (LA) strain accurately categorizes DD in adults but its role in children is unknown. Thus, the aim of this study is to investigate whether LA strain and strain rate could diagnose and classify DD in children with dilated (CMD), hypertrophic (HCM) and restrictive (RCM) cardiomyopathies (CM). Methods and Results: The study includes 136 children (aged 8.8 ± 6 years): 44 with DCM, 40 with HCM, 7 with RCM and 45 healthy controls (CTRL). They underwent standard echocardiographic examination and 2-D speckle-tracking analyses (LV longitudinal peak systolic strain (LS), LA peak systolic strain and strain rate). No significant differences in mitral E/A and pulmonary S/D ratios were observed among the four groups. Although E/E’ and indexed left atrial volumes were found to be significantly higher in HCM, DCM and RCM compared to CTRL (p < 0.001), they showed no significant difference among the three CM groups. LV LS values were significantly reduced in CM vs CTRL (p < 0.001) and in DCM vs HCM (p < 0.01), with no other differences between the remaining groups. LA peak systolic strain and strain rate values showed a steady and significant decrease with worsening of DD. Receiver Operating Characteristics (ROC) curves showed area under the curve of 0.976 (p < 0.001) for LA strain and 0.946 (p < 0.001) for LA strain rate, to distinguish CTRL from CMs. Conclusions: LA strain and strain rate could be a promising tool to better understand and classify DD in children with cardiomyopathies, opening the way to its clinical use.

Atrial Function After Surgical and Percutaneous Closure of Atrial Septal Defect: A Strain Rate Imaging Study

2005 ◽  
Vol 18 (9) ◽  
pp. 930-933 ◽  
Author(s):  
Giovanni Di Salvo ◽  
Manuela Drago ◽  
Giuseppe Pacileo ◽  
Alessandra Rea ◽  
Marianna Carrozza ◽  
...  
Keyword(s):  
Atrial Septal Defect ◽  
Strain Rate ◽  
Septal Defect ◽  
Imaging Study ◽  
Percutaneous Closure ◽  
Atrial Function ◽  
Strain Rate Imaging

Transmural Peak Systolic Strain and Strain Rate Predict Transmural Myocardial Blood Flow in a Pig Myocardial Infarction Model

Cardiology ◽  
2009 ◽  
Vol 112 (2) ◽  
pp. 122-128 ◽  
Author(s):  
Huixia Lu ◽  
Guihua Yao ◽  
Huili Lin ◽  
Xinsheng Xu ◽  
Changjiang Li ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Blood Flow ◽  
Myocardial Blood Flow ◽  
Strain Rate ◽  
Systolic Strain ◽  
Peak Systolic Strain ◽  
Strain And Strain Rate

scholarly journals Right Anterolateral Thoracotomy an Alternative to Median Sternotomy for Closure of Atrial Septal Defect: A Cosmetic Approach in Young Females

2015 ◽  
Vol 12 (1) ◽  
pp. 21-25
Author(s):  
Ravi Kumar Baral ◽  
Bhagawan Koirala
Keyword(s):  
Minimally Invasive ◽  
Atrial Septal Defect ◽  
Septal Defect ◽  
Demographic Data ◽  
Median Sternotomy ◽  
Young Females ◽  
Anterolateral Thoracotomy ◽  
Significant Difference ◽  
Asd Closure ◽  
Duration Of Operation

Background and Aims: Atrial septal defect operation is a safe and low-risk procedure. Cosmetic results have been an important issue, so right anterolateral thoracotomy approach has been used for repair. We present minimally invasive ASD closure via limited right anterolateral thoracotomy, as our early experience in road of minimally invasive cardiac surgery. Methods: This study was done in the Manmohan Cardiothoracic and Transplant Center in the time period of 2012 to 2013. The study included 70 patients aged 15 – 35 years old (22.1±5.5) admitted for surgical repair of their secundum atrial septal defects. The patients were randomly allocated into one of two groups according to the approach used in their operation. Right anterolateral thoracotomy(RALT) group included 35 patients operated via right anterolateral thoracotomy.and median sternotomy(MS) group included 35 patients operated via the median sternotomy. Result: Of 70 patients only 63 patients meet the criteria for analysis. There was no statistically significant difference between the 2 groups regarding their demographic data and duration of operation. Postoperative pleural/pericardial effusion and pneumothorax occurred in 2.1% of patients in MS and 6.6% in Right anterolateral thoracotomygroup (p= 0.001). Total in hospital pain score was high in sternotomy group than thoracotomy group, but did not reach statistically significant values. There was no operative or late mortality or morbidity in the early follow-up (range, 1 m to 2 years, mean 1.34 yrs). Conclusion: RALT is a safe and effective alternative approach to MS incision for ASD closure. DOI: http://dx.doi.org/10.3126/njh.v12i1.12340 Nepalese Heart Journal Vol.12(1) 2015: 21-25

Abstract 5781: Evaluation of Global and Regional Right Ventricular Systolic Function in Patient Prosthesis Mismatch after Mitral Valve Replacement using Velocity Vector Imaging

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Aylin Tugcu ◽  
Yelda Tayyareci ◽  
Ozlem Yildirimturk ◽  
Saide Aytekin
Keyword(s):  
Strain Rate ◽  
Velocity Vector ◽  
Systolic Function ◽  
Strain Rates ◽  
Free Wall ◽  
Systolic Strain ◽  
Peak Systolic Strain ◽  
Strain And Strain Rate ◽  
Patient Prosthesis Mismatch ◽  
Rv Function

The aim of this study was to compare right ventricular (RV) global and regional systolic function in patients with and without patient prosthesis mismatch (PPM) after isolated mitral valve replacement (MVR) using Velocity Vector Imaging (VVI) method. The PPM group consisted of 20 patients that underwent isolated MVR with an indexed effective orifice area (EOA) ≤ 1.2 cm 2 /m 2 determined by continuity equation and indexed for body surface area. The non-PPM group consisted of 20 patients that also underwent isolated MVR with an indexed EOA > 1.2cm 2 /m 2 . Echocardiographic images in apical planes were analyzed for RV volumes, ejection fractions, myocardial velocity, strain and strain rate at the basal, mid and apical segments of RV free wall and ventricular septum using VVI. The demographic and preoperative data were similar between PPM and non-PPM groups. Evidence of PA hypertension defined as systolic PA pressure > 40 mmHg was present in 50% of patients in PPM group, whereas none of the patients in non-PPM group had PA hypertension. RV volumes were significantly increased, and RV ejection fraction, peak systolic myocardial velocities, strain and strain rates were significantly impaired in patients with PPM compared to non-PPM group (p<0.001 for all). Indexed EOA correlated strongly with myocardial velocities, strain and strain rates in all segments of the RV (p<0.05 for all). Multivariate stepwise regression analysis demonstrated that indexed EOA and systolic PA pressure were the independent determinants of basal free wall peak systolic strain (β=0.547, p<0.001 and β=−0.304, p=0.033 respectively) and strain rate (β=0.497, p=0.001 and β=−0.332, p = 0.026 respectively). Using receiver-operating characteristics analysis cut-off values for basal free wall peak systolic strain and strain rate in determining patients with indexed EOA ≤ 1.2 cm 2 /m 2 were −25.62 % (sensitivity 85%, specificity 95%) and −1.87 1/s (sensitivity 95%, specificity 95%) respectively. PPM after MVR is associated with RV global and regional RV dysfunction. Two-dimensional echocardiography has some limitations in evaluating RV function due to its complex geometry. VVI is a feasible modality in assessment of RV global and regional RV function.

Right and Left Ventricular Strain and Strain Rate in Young Adults before and after Percutaneous Atrial Septal Defect Closure

2011 ◽  
Vol 28 (7) ◽  
pp. 730-737 ◽  
Author(s):  
Claudio Bussadori ◽  
Pedro Oliveira ◽  
Carmelo Arcidiacono ◽  
Antonio Saracino ◽  
Elisa Nicolosi ◽  
...  
Keyword(s):  
Young Adults ◽  
Atrial Septal Defect ◽  
Strain Rate ◽  
Septal Defect ◽  
Left Ventricular ◽  
Defect Closure ◽  
Atrial Septal Defect Closure ◽  
Left Ventricular Strain ◽  
Strain And Strain Rate ◽  
Before And After

Longitudinal strain and strain rate by tissue Doppler are more sensitive indices than fractional shortening for assessing the reduced myocardial function in asphyxiated neonates

2010 ◽  
Vol 21 (1) ◽  
pp. 1-7 ◽  
Author(s):  
Eirik Nestaas ◽  
Asbjørn Støylen ◽  
Leif Brunvand ◽  
Drude Fugelseth
Keyword(s):  
Strain Rate ◽  
Myocardial Function ◽  
Troponin T ◽  
Tissue Doppler ◽  
Systolic Strain ◽  
Term Neonates ◽  
Peak Systolic Strain ◽  
Strain And Strain Rate ◽  
Apical Group ◽  
Fractional Shortening

AbstractThe function of the heart was studied in 20 asphyxiated term neonates by measuring the longitudinal peak systolic strain and peak systolic strain rate by tissue Doppler in 18 segments of the heart on days 1, 2, and 3 of life. The fractional shortening was assessed at each examination as well. Measurements were compared against measurements in 48 healthy term neonates examined by the same protocol. The function of the heart was lower in the asphyxiated neonates – peak systolic strain (mean (95% confidence interval) −19.4% (−20.4, −18.5), peak systolic strain rate −1.65 (−1.74, −1.56) per second) than in the healthy term neonates (peak systolic strain −21.7% (−22.3, −21.0), peak systolic strain rate −1.78 (−1.84, −1.74) per second; p < 0.001). Fractional shortening was similar in the asphyxiated (29.2% (26.8, 31.5)) and healthy term neonates (29.0% (27.9, 30.1); p = 0.874). The peak systolic strain differed significantly between the asphyxiated and healthy term neonates for the left basal and right basal groups of segments (p < 0.05) but not for the left apical, right apical, septum apical, or septum basal groups of segments. The peak systolic strain rate differed significantly only for the septum apical group of segments. The differences were largest on the second day of life. Measurements were similar in asphyxiated neonates with elevated and normal cardiac troponin T levels. The peak systolic strain and strain rate were in this study more sensitive indices than fractional shortening for assessing the reduced myocardial function in asphyxiated term neonates.

scholarly journals Lipopolysaccharide acutely suppresses right-ventricular strain in rats with pulmonary artery hypertension

2017 ◽  
Vol 8 (1) ◽  
pp. 204589321774450 ◽  
Author(s):  
Junjie Zhang ◽  
Yanan Cao ◽  
Xiaowei Gao ◽  
Maoen Zhu ◽  
Zhong Zhang ◽  
...  
Keyword(s):  
Pulmonary Artery ◽  
Right Ventricular ◽  
Strain Rate ◽  
Acute Inflammation ◽  
Pulmonary Artery Hypertension ◽  
Left Ventricular ◽  
Systolic Strain ◽  
Peak Systolic Strain ◽  
Strain And Strain Rate ◽  
Rv Function

Worsening right ventricular (RV) dysfunction in the presence of pulmonary artery hypertension (PAH) increases morbidity and mortality in this patient population. Transthoracic echocardiography (TTE) is a non-invasive modality to evaluate RV function over time. Using a monocrotaline-induced PAH rat model, we evaluated the effect of acute inflammation on RV function. In this study, both PAH and control rats were injected with Escherichia coli lipopolysaccharide (LPS) to induce an acute inflammatory state. We evaluated survival curves, TTE parameters, and inflammatory markers to better understand the mechanism and impact of acute inflammation on RV function in the presence of PAH. The survival curve of the PAH rats dropped sharply within 9 h after LPS treatment. Several echocardiographic parameters including left ventricular (LV) stroke volume, RV tricuspid annular plane systolic excursion, RV longitudinal peak systolic strain, and strain rate decreased significantly in PAH rats before LPS injection and 2 h after LPS injection. The expression of phospholamban (PLB) and tumor necrosis factor-α (TNF-α) significantly increased and the expression of SERCA2a significantly decreased in PAH rats after LPS administration. LPS suppressed the RV longitudinal peak systolic strain and strain rate and cardiac function deteriorated in PAH rats. These effects may be associated with the signal pathway activity of SERCA2a/PLB.

scholarly journals Analysis of Remifentanil-Based Fast-Track Anesthesia Combined with Dexmedetomidine for Transthoracic Device Closure of Atrial Septal Defect in Pediatric Patients

2021 ◽  
Vol 24 (2) ◽  
pp. E233-E238
Author(s):  
Ling-shan Yu ◽  
Yu-qing Lei ◽  
Jian-feng Liu ◽  
Jing Wang ◽  
Hua Cao ◽  
...  
Keyword(s):  
Atrial Septal Defect ◽  
Fast Track ◽  
Pediatric Patients ◽  
Septal Defect ◽  
Device Closure ◽  
Pain Scores ◽  
Postoperative Intensive Care ◽  
Significant Difference ◽  
Postoperative Intensive Care Unit ◽  
Asd Closure

Background: To investigate the safety and efficacy of remifentanil combined with dexmedetomidine in fast-track cardiac anesthesia (FTCA) for transthoracic device closure of atrial septal defect (ASD) in pediatric patients. Methods: A retrospective analysis was performed on 61 cases of children undergoing ASD closure through a small thoracic incision from January 2018 to January 2020. According to whether FTCA was administered, they were divided into group F (fast-track anesthesia, n = 31) and group R (routine anesthesia, n = 30). Results: There was no significant difference in general preoperative data, perioperative hemodynamics, or postoperative pain scores between the 2 groups (P > .05). The postoperative sedation score of group F was higher than that of group R 1 and 4 hours after extubation. Meanwhile, duration of mechanical ventilation and length of postoperative intensive care unit (ICU) stay of group F were significantly shorter than those of group R (P < .05). No serious anesthesia-related complications occurred. Conclusion: Remifentanil combined with dexmedetomidine in FTCA for transthoracic device closure of ASD in pediatric patients is safe and effective, is worthy of clinical promotion, and can benefit more children.

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