Right Ventricular function using Speckle Tracking Echocardiography and Reversibility Of pulmonary Hypertention in simple cardiac shunts

ABSTRACTBackground: This study was conducted to evaluate the results of simple cardiac shunt closure using trans catherer device regarding right ventricular function using speckle tracking and reversibility of pulmonary hypertention,testing the ability of echocardiography to provide unique noninvasive information with minimal risk, we aimed to detect right ventricular function in simple cardiac shunt patients before closure using longitudinal strain and to investigate its role in predicting reversibility of pulmonary hypertention after closure Methods: This is a prospective randomized comparative study including simple shunt patients who presented to cardiology department from September 2018 to July 2019. Our patients were divided into two groups Group I: ten patients were having irreversible pulmonary hypertension.Group II: Twenty patients, were having reversible pulmonary hypertension. Results: There was statistically significant increase in group II post closure regarding LVEF,RVFAC,TAPSE,SRV, RVLS (P< 0.05). While PASP showed significant decrease in GII post closure (P < 0.05). On the other hand, RVLS was negatively correlated with the defect size , Qp/Qs, PASP. And significant positive correlation with SRV, RVFAC,TAPSE. RVLS value of ≥ -20 could predict reversibility of PASP Conclusion: The RVLS value of ≥-20 could predict reversibility of PASP with AUC 0.9 suggesting strong accuracy (P< 0.001). RVLS correctly identify simple shunt patients with increased PASP (sensitivity 80%), and it correctly reports 85 % of simple shunt patients without increased PASP as true negatives, while 15% are incorrectly identified as false positive with specificity 85%.