DOI QR코드

DOI QR Code

SEGMENTAL ANALYSIS OF RIGHT VENTRICULAR LONGITUDINAL DEFORMATION IN CHILDREN BEFORE AND AFTER PERCUTANEOUS CLOSURE OF ATRIAL SEPTAL DEFECT

  • Ko, Hong Ki (Department of Pediatrics, Ajou University School of Medicine) ;
  • Yu, Jeong Jin (Division of Pediatric Cardiology, College of Medicine, University of Ulsan) ;
  • Cho, Eun Kyung (Division of Pediatric Cardiology, College of Medicine, University of Ulsan) ;
  • Kang, So Yeon (Division of Pediatric Cardiology, College of Medicine, University of Ulsan) ;
  • Seo, Chang Deok (Division of Pediatric Cardiology, College of Medicine, University of Ulsan) ;
  • Baek, Jae Suk (Division of Pediatric Cardiology, College of Medicine, University of Ulsan) ;
  • Kim, Young-Hwue (Division of Pediatric Cardiology, College of Medicine, University of Ulsan) ;
  • Ko, Jae-Kon (Division of Pediatric Cardiology, College of Medicine, University of Ulsan)
  • 투고 : 2014.09.01
  • 심사 : 2014.11.27
  • 발행 : 2014.12.27

초록

BACKGROUND: The aim of study is to identify the dependence of right ventricular (RV) free wall longitudinal deformation on ventricular loading through segmental approach in relatively large number of patients with atrial septal defect (ASD). METHODS: Patients with ASD (n = 114) and age matched healthy children (n = 60) were echocardiographically examined the day before percutaneous device closure and within 24 hours afterwards. RV free wall deformation parameters, strain (${\epsilon}$) and strain rate (SR), were analyzed in the apical (${\epsilon}_A$, $SR_A$) and basal (${\epsilon}_B$, $SR_B$) segments. Measured deformation parameters were adjusted for RV size (${\epsilon}_{AL}$, $SR_{AL}$, ${\epsilon}_{BL}$, $SR_{BL}$) by multiplying by body surface area indexed RV longitudinal dimension. Regression analyses determined the relationships of these deformation parameters with RV loading parameters that were measured by catheterization. RESULTSE: ${\epsilon}_{BL}$ and $SR_{BL}$ were not different between pre-closure patients and controls (p = 0.245, p = 0.866), and were decreased post-closure (p = 0.001, p = 0.018). Post-closure ${\epsilon}_{BL}$ was lower than in controls (p = 0.001). Pre-closure ${\epsilon}_{AL}$ and $SR_{AL}$ were higher than in controls (p = 0.001, p < 0.001), but decreased after closure (all p < 0.001). The pulmonary to systemic flow ratio was related to procedural differences of ${\epsilon}_{BL}$ (p = 0.017) and of $SR_{BL}$ (p = 0.019). RV end diastolic pressure was negatively related to post-closure ${\epsilon}_{BL}$ (p = 0.020) and post-closure $SR_{BL}$ (p = 0.012), and the procedural $SR_{BL}$ difference (p = 0.027). CONCLUSION: The longitudinal deformation of the RV basal segment is dependent and its remodeling is also dependent on volume loading in children with ASD.

키워드

참고문헌

  1. Hoffman JI, Kaplan S. The incidence of congenital heart disease. J Am Coll Cardiol 2002;39:1890-900. https://doi.org/10.1016/S0735-1097(02)01886-7
  2. Jeong JA, Kim YM, Lee HS, Kwon TC, Kang CM. Statistical study on congenital heart disease. Korean Circ J 1989;19:89-96. https://doi.org/10.4070/kcj.1989.19.1.89
  3. Hoffman JI, Christianson R. Congenital heart disease in a cohort of 19,502 births with long-term follow-up. Am J Cardiol 1978;42:641-7. https://doi.org/10.1016/0002-9149(78)90635-5
  4. Craig RJ, Selzer A. Natural history and prognosis of atrial septal defect. Circulation 1968;37:805-15. https://doi.org/10.1161/01.CIR.37.5.805
  5. Attie F, Rosas M, Granados N, Zabal C, Buendia A, Calderon J. Surgical treatment for secundum atrial septal defects in patients >40 years old. A randomized clinical trial. J Am Coll Cardiol 2001;38:2035-42. https://doi.org/10.1016/S0735-1097(01)01635-7
  6. Konstantinides S, Geibel A, Olschewski M, Görnandt L, Roskamm H, Spillner G, Just H, Kasper W. A comparison of surgical and medical therapy for atrial septal defect in adults. N Engl J Med 1995;333:469-73. https://doi.org/10.1056/NEJM199508243330801
  7. D'hooge J, Heimdal A, Jamal F, Kukulski T, Bijnens B, Rademakers F, Hatle L, Suetens P, Sutherland GR. Regional strain and strain rate measurements by cardiac ultrasound: principles, implementation and limitations. Eur J Echocardiogr 2000;1:154-70. https://doi.org/10.1053/euje.2000.0031
  8. Rudski LG, Lai WW, Afilalo J, Hua L, Handschumacher MD, Chandrasekaran K, Solomon SD, Louie EK, Schiller NB. Guidelines for the echocardiographic assessment of the right heart in adults: a report from the American Society of Echocardiography endorsed by the European Association of Echocardiography, a registered branch of the European Society of Cardiology, and the Canadian Society of Echocardiography. J Am Soc Echocardiogr 2010;23:685-713; quiz 786-8. https://doi.org/10.1016/j.echo.2010.05.010
  9. Missant C, Rex S, Claus P, Mertens L, Wouters PF. Load-sensitivity of regional tissue deformation in the right ventricle: isovolumic versus ejectionphase indices of contractility. Heart 2008;94:e15.
  10. Dambrauskaite V, Delcroix M, Claus P, Herbots L, D'hooge J, Bijnens B, Rademakers F, Sutherland GR. Regional right ventricular dysfunction in chronic pulmonary hypertension. J Am Soc Echocardiogr 2007;20:1172-80. https://doi.org/10.1016/j.echo.2007.02.005
  11. Sutherland GR, Di Salvo G, Claus P, D'hooge J, Bijnens B. Strain and strain rate imaging: a new clinical approach to quantifying regional myocardial function. J Am Soc Echocardiogr 2004;17:788-802. https://doi.org/10.1016/j.echo.2004.03.027
  12. Kjaergaard J, Sogaard P, Hassager C. Right ventricular strain in pulwall monary embolism by Doppler tissue echocardiography. J Am Soc Echocardiogr 2004;17:1210-2. https://doi.org/10.1016/j.echo.2004.06.026
  13. Chow PC, Liang XC, Cheung EW, Lam WW, Cheung YF. New two-dimensional global longitudinal strain and strain rate imaging for assessment of systemic right ventricular function. Heart 2008;94:855-9. https://doi.org/10.1136/hrt.2007.131862
  14. Eyskens B, Ganame J, Claus P, Boshoff D, Gewillig M, Mertens L. Ultrasonic strain rate and strain imaging of the right ventricle in children before and after percutaneous closure of an atrial septal defect. J Am Soc Echocardiogr 2006;19:994-1000. https://doi.org/10.1016/j.echo.2006.02.001
  15. Abd El Rahman MY, Hui W, Timme J, Ewert P, Berger F, Dsebissowa F, Hetzer R, Lange PE, Abdul-Khaliq H. Analysis of atrial and ventricular performance by tissue Doppler imaging in patients with atrial septal defects before and after surgical and catheter closure. Echocardiography 2005;22:579-85. https://doi.org/10.1111/j.1540-8175.2005.40019.x
  16. Van De Bruaene A, Buys R, Vanhees L, Delcroix M, Voigt JU, Budts W. Regional right ventricular deformation in patients with open and closed atrial septal defect. Eur J Echocardiogr 2011;12:206-13. https://doi.org/10.1093/ejechocard/jeq169
  17. Dragulescu A, Grosse-Wortmann L, Redington A, Friedberg MK, Mertens L. Differential effect of right ventricular dilatation on myocardial deformation in patients with atrial septal defects and patients after tetralogy of Fallot repair. Int J Cardiol 2013;168:803-10. https://doi.org/10.1016/j.ijcard.2012.10.009
  18. Bussadori C, Oliveira P, Arcidiacono C, Saracino A, Nicolosi E, Negura D, Piazza L, Micheletti A, Chessa M, Butera G, Dua JS, Carminati M. Right and left ventricular strain and strain rate in young adults before and after percutaneous atrial septal defect closure. Echocardiography 2011;28:730-7. https://doi.org/10.1111/j.1540-8175.2011.01434.x
  19. Di Salvo G, Drago M, Pacileo G, Carrozza M, Santoro G, Bigazzi MC, Caso P, Russo MG, Carminati M, Calabro R. Comparison of strain rate imaging for quantitative evaluation of regional left and right ventricular function after surgical versus percutaneous closure of atrial septal defect. Am J Cardiol 2005;96:299-302. https://doi.org/10.1016/j.amjcard.2005.02.060
  20. Jategaonkar SR, Scholtz W, Butz T, Bogunovic N, Faber L, Horstkotte D. Two-dimensional strain and strain rate imaging of the right ventricle in adult patients before and after percutaneous closure of atrial septal defects. Eur J Echocardiogr 2009;10:499-502. https://doi.org/10.1093/ejechocard/jen315
  21. Haycock GB, Schwartz GJ, Wisotsky DH. Geometric method for measuring body surface area: a height-weight formula validated in infants, children, and adults. J Pediatr 1978;93:62-6. https://doi.org/10.1016/S0022-3476(78)80601-5
  22. Galderisi M, Benjamin EJ, Evans JC, D'Agostino RB, Fuller DL, Lehman B, Wolf PA, Levy D. Intra- and interobserver reproducibility of Doppler-assessed indexes of left ventricular diastolic function in a population-based study (the Framingham Heart Study). Am J Cardiol 1992;70:1341-6. https://doi.org/10.1016/0002-9149(92)90772-Q
  23. Marciniak A, Claus P, Sutherland GR, Marciniak M, Karu T, Baltabaeva A, Merli E, Bijnens B, Jahangiri M. Changes in systolic left ventricular function in isolated mitral regurgitation. A strain rate imaging study. Eur Heart J 2007;28:2627-36. https://doi.org/10.1093/eurheartj/ehm072
  24. Naito H, Arisawa J, Harada K, Yamagami H, Kozuka T, Tamura S. Assessment of right ventricular regional contraction and comparison with the left ventricle in normal humans: a cine magnetic resonance study with presaturation myocardial tagging. Br Heart J 1995;74:186-91. https://doi.org/10.1136/hrt.74.2.186
  25. Teske AJ, Prakken NH, De Boeck BW, Velthuis BK, Martens EP, Doevendans PA, Cramer MJ. Echocardiographic tissue deformation imaging of right ventricular systolic function in endurance athletes. Eur Heart J 2009;30:969-77.

피인용 문헌

  1. Evaluation of right ventricular myocardial strains by speckle tracking echocardiography after percutaneous device closure of atrial septal defects in children vol.35, pp.8, 2014, https://doi.org/10.1111/echo.14006