Background. Evaluation of global and regional right ventricular (RV) systolic and diastolic function in atrial septal defects (ASD) is still a challenging post-surgical clinical problem, especially in adult patients (pts) We investigated whether high frame rate tissue Doppler imaging (TDI, Toshiba corp.) may provide quantitative assessment of RV function in ASD pts. Methods. Twenty-three pts with ostium secundum ASD, aged 25±9 years, were studied with transesophageal echocardiography. Twelve pts underwent corrective surgery. 11 subjects with no signs of heart disease were used as a control group. ASD pts were classified in 3 groups according to 2D/color Doppler defect and shunt size (group “1” large, group “2” medium, group “3” small). Peak mean systolic (Sw) and diastolic (Ew, Aw) wall velocities were acquired from the 4-chamber view in the myocardia [septum (IVS) and free wall (FW)]. TDI wall velocities during systole (Sa), early relaxation (Ea) and atrial systole (Aa) were also measured in the tricuspid annulus. Satisfactory TDI data could be obtained in all pts at end expiration, independent of quality of RV wall motion. Results. Compared to controls, group “1” pts had lower mean FW velocities (Sw= 5.5±1.9 vs 8.3±2.1 cm/s – p<0.005 –; Ew=5.8±1.9 vs 9.4±2.2 cm/s – p< 0.001 –; Aw=3.5±1.4 vs 3.6±1.8 cm/s – p=NS –) and lower annulus velocities both in systole and diastole (Sa =5.3±1.3 vs 8.9±1.3 cm/s – p<0.001 – ; Ea = 6.2±2.4 vs 13.3±2.4 cm/s – p< 0.001 – ; Aa = 7.8±2.2 vs 7.1±2.3 cm/s – p=NS – ). Also, group “1” pts had lower mean FW Sw and Ew velocities compared to IVS wall velocities (p < 0.005). Group “2” pts had preserved systolic velocities but decreased regional and annular early diastolic velocities suggesting impaired relaxation (Ea/Aa 0.87±0.28 vs 1.64±0.31 – p<0.0001 – ). Group “3” pts had preserved systolic and diastolic velocities. Conclusion. Thus, TDI is useful in evaluating systolic and diastolic RV abnormalities, could corroborate the need of surgery in pts with volume overload, and may aid in monitoring RV function during post-surgical followup.
Transesophageal echocardiography with tissue Doppler imaging in the assessment of global and regional systolic and diastolic right ventricular function in atrial septal defects / Vitarelli, Antonino; Conde, Y; Cimino, E; Leone, T; D'Orazio, Simona; Colantonio, R; D'Angeli, Ilaria; Stellato, Simona. - In: JOURNAL OF CARDIAC FAILURE. - ISSN 1071-9164. - STAMPA. - 9:(2003), p. 82. (Intervento presentato al convegno 7th Annual Scientific Meeting of HFSA tenutosi a Las Vegas,USA nel 21-24 Sett. 2003).
Transesophageal echocardiography with tissue Doppler imaging in the assessment of global and regional systolic and diastolic right ventricular function in atrial septal defects.
VITARELLI, Antonino;D'ORAZIO, SIMONA;D'ANGELI, ILARIA;STELLATO, SIMONA
2003
Abstract
Background. Evaluation of global and regional right ventricular (RV) systolic and diastolic function in atrial septal defects (ASD) is still a challenging post-surgical clinical problem, especially in adult patients (pts) We investigated whether high frame rate tissue Doppler imaging (TDI, Toshiba corp.) may provide quantitative assessment of RV function in ASD pts. Methods. Twenty-three pts with ostium secundum ASD, aged 25±9 years, were studied with transesophageal echocardiography. Twelve pts underwent corrective surgery. 11 subjects with no signs of heart disease were used as a control group. ASD pts were classified in 3 groups according to 2D/color Doppler defect and shunt size (group “1” large, group “2” medium, group “3” small). Peak mean systolic (Sw) and diastolic (Ew, Aw) wall velocities were acquired from the 4-chamber view in the myocardia [septum (IVS) and free wall (FW)]. TDI wall velocities during systole (Sa), early relaxation (Ea) and atrial systole (Aa) were also measured in the tricuspid annulus. Satisfactory TDI data could be obtained in all pts at end expiration, independent of quality of RV wall motion. Results. Compared to controls, group “1” pts had lower mean FW velocities (Sw= 5.5±1.9 vs 8.3±2.1 cm/s – p<0.005 –; Ew=5.8±1.9 vs 9.4±2.2 cm/s – p< 0.001 –; Aw=3.5±1.4 vs 3.6±1.8 cm/s – p=NS –) and lower annulus velocities both in systole and diastole (Sa =5.3±1.3 vs 8.9±1.3 cm/s – p<0.001 – ; Ea = 6.2±2.4 vs 13.3±2.4 cm/s – p< 0.001 – ; Aa = 7.8±2.2 vs 7.1±2.3 cm/s – p=NS – ). Also, group “1” pts had lower mean FW Sw and Ew velocities compared to IVS wall velocities (p < 0.005). Group “2” pts had preserved systolic velocities but decreased regional and annular early diastolic velocities suggesting impaired relaxation (Ea/Aa 0.87±0.28 vs 1.64±0.31 – p<0.0001 – ). Group “3” pts had preserved systolic and diastolic velocities. Conclusion. Thus, TDI is useful in evaluating systolic and diastolic RV abnormalities, could corroborate the need of surgery in pts with volume overload, and may aid in monitoring RV function during post-surgical followup.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
