Key result
Patients with secundum atrial septal defect had significantly reduced left ventricular peak twist compared to healthy controls (11.9 ± 5.9° vs 14.6 ± 3.5°) due to heterogeneous basal rotation.
Case-Control (n=90)
Single-blind
No
Absolute Event Rate: 11.9% vs 14.6%
p-value: p=0.012
In asymptomatic adults with secundum ASD, left ventricular systolic twist is significantly reduced due to heterogeneous basal rotation, which correlates with reduced ejection fraction and increased pulmonary-to-systemic flow ratio.
Does not warrant changes in secundum ASD management; hypothesis-generating for LV mechanics and requires prospective validation.
BACKGROUND: Recently, assessment of left ventricular (LV) torsional deformation has become an important approach for quantifying LV function. This study sought to evaluate LV torsion using speckle tracking imaging in patients with atrial septal defect (ASD). METHODS AND RESULTS: Basal and apical LV short-axis images were analyzed in 45 asymptomatic adults with isolated secundum ASD and 45 matched normal subjects. The apical rotation parameters were similar between 2 groups; however, the peak basal clockwise rotation was significantly depressed (-5.4 +/-2.8 degrees vs -6.9 +/-2.6 degrees , P<0.001) and time to the peak was significantly delayed (118.3 +/-18.8% vs 96.1 +/-12.6% of systolic period, P<0.001) in patients with ASD. The peak basal initial counterclockwise rotation in the ASD group was significantly higher (5.1 +/-3.3 degrees vs 1.8 +/-1.4 degrees , P<0.001) and longer (75.4 +/-26.7% vs 42.5 +/-24.4% of systolic period, P<0.001) than that in the control group. LV peak twist was also reduced significantly in patients with ASD (11.9 +/-5.9 degrees vs 14.6 +/-3.5 degrees , P<0.05) in comparison with the controls. CONCLUSIONS: LV systolic twist was significantly reduced in patients with ASD mainly because of the heterogeneous basal rotation.
No takes yet. Share an insight, caveat, or question.
Dong et al. (2009) conducted a case-control in Secundum Atrial Septal Defect (n=90). Secundum Atrial Septal Defect vs. Matched normal subjects was evaluated on Left ventricular peak twist (degrees) (p=0.012). Patients with secundum atrial septal defect had significantly reduced left ventricular peak twist compared to healthy controls (11.9 ± 5.9° vs 14.6 ± 3.5°) due to heterogeneous basal rotation.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: