Background. The purpose of the present study was to analyze segmental atrial function by three-dimensional speckle-tracking echocardiography (3DSTE) in patients with patent foramen ovale six months after the implantation of occluder devices.. Methods. Patients with atrial septal devices (n = 65) were followed up for six months after device implantation and compared with a normal age-matched group (n = 35). A subgroup of 12 patients who developed paroxysmal atrial fibrillation (PAF) after device insertion were also studied. Atrial peak ventricular systolic longitudinal strain (LS), circumferential strain (CS), and area strain (AS) and peak pre–atrial contraction longitudinal strain, circumferential strain, and area strain were determined using 3D STE, and SDs of times to peaks of regional atrial strain were calculated as indices of dyssynchrony. 3DSTE was able to measure atrial strain in 62 of the 65 implanted patients and in all patients with PAF. Results. The mean time for analysis with 3D STE was 20% shorter than with two-dimensional speckle-tracking echocardiography (p<0.05). Values of interobserver and intraobserver variability of atrial strain by 3DSTE were <11% and <13%, respectively. LS, CS, and AS were reduced in patients with atrial devices compared with controls, and further reductions of these parameters were observed in patients with PAF. By multivariate analysis, LS (p=0.002), AS (p<0.001), and CS (p<0.05) were independent predictors of PAF. Patients with PAF showed smaller peak pre–atrial contraction longitudinal strain and peak pre–atrial contraction area strain compared with controls. Conclusions. Patients with atrial septal devices have significant global and segmental atrial dysfunction as assessed by 3DSTE. The localized regional dysfunction is likely due to the direct mechanical effect associated with occluder implantation. This may have implications for the evaluation of long term atrial function and selection of devices of appropriate sizes.
Assessment of left and right atrial function by three-dimensional speckle tracking echocardiography following percutaneous closure of patent foramen ovale / Vitarelli, Antonino; Mangieri, Enrico; Tanzilli, Gaetano; Capotosto, Lidia; A., Azzano; K., Mukred; M., De Maio; R., Ashurov. - In: CARDIOLOGY. - ISSN 1421-9751. - STAMPA. - 128(Suppl 1):(2014), pp. 488-488. (Intervento presentato al convegno 19th World Congress on Heart Disease tenutosi a Boston, MA, USA nel July 25-28, 2014).
Assessment of left and right atrial function by three-dimensional speckle tracking echocardiography following percutaneous closure of patent foramen ovale
VITARELLI, Antonino;MANGIERI, Enrico;TANZILLI, Gaetano;CAPOTOSTO, LIDIA;
2014
Abstract
Background. The purpose of the present study was to analyze segmental atrial function by three-dimensional speckle-tracking echocardiography (3DSTE) in patients with patent foramen ovale six months after the implantation of occluder devices.. Methods. Patients with atrial septal devices (n = 65) were followed up for six months after device implantation and compared with a normal age-matched group (n = 35). A subgroup of 12 patients who developed paroxysmal atrial fibrillation (PAF) after device insertion were also studied. Atrial peak ventricular systolic longitudinal strain (LS), circumferential strain (CS), and area strain (AS) and peak pre–atrial contraction longitudinal strain, circumferential strain, and area strain were determined using 3D STE, and SDs of times to peaks of regional atrial strain were calculated as indices of dyssynchrony. 3DSTE was able to measure atrial strain in 62 of the 65 implanted patients and in all patients with PAF. Results. The mean time for analysis with 3D STE was 20% shorter than with two-dimensional speckle-tracking echocardiography (p<0.05). Values of interobserver and intraobserver variability of atrial strain by 3DSTE were <11% and <13%, respectively. LS, CS, and AS were reduced in patients with atrial devices compared with controls, and further reductions of these parameters were observed in patients with PAF. By multivariate analysis, LS (p=0.002), AS (p<0.001), and CS (p<0.05) were independent predictors of PAF. Patients with PAF showed smaller peak pre–atrial contraction longitudinal strain and peak pre–atrial contraction area strain compared with controls. Conclusions. Patients with atrial septal devices have significant global and segmental atrial dysfunction as assessed by 3DSTE. The localized regional dysfunction is likely due to the direct mechanical effect associated with occluder implantation. This may have implications for the evaluation of long term atrial function and selection of devices of appropriate sizes.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
