Evaluation of right ventricular myocardial strains by speckle tracking echocardiography after percutaneous device closure of atrial septal defects in children

OBJECTIVES: The aim of this study was to clarify the influence of the ASD closure by occluder device on right ventricular acute and long-term changes in longitudinal systolic strains, by evaluating right ventricular wall deformation in children using speckle tracking echocardiography (STE). METHODS AND MATERIALS: We enrolled 30 children with ASDs and 40 controls in our study. The Amplatzer atrial defect occluder was used to close the ASDs. Transthoracic echocardiographic examinations were performed at 3 points in time: the day before closure, 1 day after closure, and 3 months after closure. The dimensions of the right atrium (RA) and the right ventricle (RV) were measured in apical four-chamber view. RV segmental longitudinal systolic strains (SLSs) and global longitudinal systolic strain (GLS) were obtained by two-dimensional STE. RESULTS: Before ASD closure, the RV SLSs and GLS were significantly higher than those of the controls. At 1 day after closure, the diameters of RA and RV decreased. All the RV SLSs and GLS decreased accordingly and were lower than the control values. At 3 months after closure, the apical free wall strain, all segments of septal strains, and GLS increased significantly compared with the values obtained at 1 day after closure. The diameters of the RA and RV decreased further as well. There were no significant differences in the strains compared with the control values, except for the free wall basal strain. CONCLUSIONS: Transcatheter device closure of ASDs improves RV strain indices and RV function recover to normal over 3 months.