Key result
Correction of atrial septal defect significantly improved right ventricular global longitudinal strain from -26.10 at baseline to -21.70 at 6 months, with changes detectable as early as 48 hours.
Why the study?
Atrial septal defect causes RV volume overload with variable effects on the LV, and 2D strain analysis provides a new tool to objectively assess biventricular systolic function and hemodynamic changes before and after correction.
Does ASD correction improve ventricular function assessed by strain imaging in patients with ostium secundum ASD?
Observational (n=32)
Does ASD correction improve ventricular function assessed by strain imaging in patients with ostium secundum ASD?
Absolute Event Rate: -21.7% vs -26.1%
p-value: p=0.0001
Correction of atrial septal defect leads to significant early improvement in right ventricular function as assessed by global longitudinal strain, with more subtle changes in left ventricular function over 6 months.
May support early RV GLS monitoring post-ASD correction; leaves open whether changes predict outcomes in prospective trials.
Background: Atrial septal defect (ASD) is a common congenital heart disease associated with volume overload of Right ventricle (RV) with variable effect on Left ventricle (LV). Two-dimensional (2D) Strain analysis is a new tool for objective analysis of myocardial function. This prospective study evaluated the systolic function of right and left ventricle by conventional 2D echo and strain echo and measured changes in cardiac hemodynamics that occurred in patients of ASD before and after correction. Patients and Methods: 2D echo and strain analysis of each patient before and at 48 hrs, 3 months and 6 months after correction was performed. Routine 2D echo parameters and global longitudinal strain of both ventricles were measured. Result: Improvement in LV ejection fraction (P = 0.0001) and myocardial performance index (MPI) (P < 0.0001) occurred at the end of 6 months, whereas decrease in RV MPI (P < 0.0001) and tricuspid annular plane systolic excursion (P < 0.0001) became statistically significant after 3 months of ASD correction. In comparison to conventional 2D echo, global longitudinal strain of RV decreased significantly only after 48 hours of ASD correction while there was no improvement in left ventricular global longitudinal strain after 6 month of correction. Conclusion: There was improvement in RV function with subtle change in LV function by strain imaging and most of these changes were completed within 6 months of ASD correction and nearly correlated with conventional 2DEchocardiography.
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Kumar et al. (2019) conducted an observational in Ostium secundum atrial septal defect (n=32). Atrial septal defect correction vs. Baseline (pre-correction) was evaluated on Right ventricular global longitudinal strain at 6 months (p=0.0001). Correction of atrial septal defect significantly improved right ventricular global longitudinal strain from -26.10 at baseline to -21.70 at 6 months, with changes detectable as early as 48 hours.
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